What are the responsibilities and job description for the Provider Enrollment Specialist II position at Easterseals MORC Logo?
Easterseals MORC is hiring for a Provider Enrollment Specialist to help make a difference and become part of something bigger than yourself!
We are looking for Game Changers!
The types of people who wake up excited to make a difference. The superheroes of their field who care about the people they serve. If that sounds like you, we want you on our team.
Benefits of Being a Superhero!
Benefits:
- Low-cost Dental/Health/Vision insurance
- Dependent care reimbursement, and up to 5 days paid FMLA for maternity, paternity, foster care and adoption.
- Generous 401K retirement plan
- Paid Leave Options Available
- Up to $125 bonus for taking 5 days off in a row.
- 10 paid holidays and 3 floating holidays (Over 30 days total of paid time off)
- Wellness Programs
- We are a PSLF (Public Service Loan Forgiveness) Employer.
- We provide bonuses and extra incentives to reward hard work & dedication.
- Mileage reimbursement in accordance with IRS rate.
- Free financial planning services through our partnerships with the LoVasco Consulting Group, and SoFi.
- Student loan repayment options
- Pet Insurance
Qualifications:
- High School Diploma or equivilent
- Two years experience in clinic, business, or medical office preferred
- One year of Provider Enrollment exprience preferred
- Excellent organizational and project planning skills with the ability to work on several projects simultaneously, work well under pressure, and meet deadlines.
Duties and Responsibilities
- Facilitate enrollment of new Easterseals MORC providers to ensure proper and timely billing and collections
- Prepare enrollment applications for all health plans including Medicare and Medicaid
- Complete data entry and processing of enrollment applications, with validation of provider submitted information to ensure the application is complete, accurate, and meeting Easterseals MORC standards
- Obtain licensure, certification and insurance certificates at time of enrollment and maintain in database in order to submit with enrollment applications
- Maintain timelines on enrollment processes, and address and/or escalate any delays
- Ensure that all pending enrollments are reviewed, obtained and managed according to the rules and policies of the department
- Provide monthly notification of new providers, resignations, and changes in provider status such as practice locations and panel status to contracted plans
- Follow up with necessary contacts, including providers and managed care organizations, to resolve enrollment application issues and deficiencies
- Facilitate resolution of provider related denials to ensure appeal procedures are followed to result in proper reimbursement
- Demonstrate a level of competence and understanding of all state and federal laws, rules and regulations according to payer guidelines for billing
Salary : $125