Provider Enrollment Specialist

POSITION SUMMARY: The Provider Enrollment Specialist is responsible for the timely and accurate completion of all payer enrollment applications across Bridgeview Eye Partners’ service lines. This includes government, managed care, and commercial payers. Key duties involve preparing applications, coordinating with operations team to obtain required provider information, and routinely monitoring pending submissions to ensure deficiencies are resolved promptly.

This position is eligible for remote work. 

WHAT WE OFFER:
• Competitive hourly wage based upon experience
• 6.5 paid holidays 2 Floating Holidays
• Approximately 10 days of PTO within first year
• Full slate of benefits, including health, dental, vision, and 401(k)

ESSENTIAL RESPONSIBILITIES:
• Collect and verify all documentation required for provider and facility payer enrollments
• Complete provider enrollment, hospital credentialing, and professional licensure applications accurately and within required timeframes while maintaining high ethical standards
• Submit payer applications in accordance with government regulations and payer specific requirements
• Maintain credentialing and enrollment processes, databases, and payer portals with a high level of accuracy, including Availity, CAQH, NaviNet, NPPES, and PECOS
• Research and resolve provider and facility enrollment issues, collaborating with internal departments as needed
• Monitor providers for timely completion of revalidations, license renewals, and other required updates
• Support the Credentialing Manager and key stakeholders with new facilities, including enrollment of new locations and providers in expanding markets
• Escalate unresolved credentialing issues or enrollment deficiencies to the Credentialing Manager when appropriate
• Perform other duties as assigned

EDUCATION, EXPERIENCE, AND CERTIFICATION:
• High School Diploma or equivalent required.
• Bachelor’s degree in Business, Healthcare Administration or related degree preferred
• 3 years of experience in payer relations, market access, and/or managed care within the healthcare industry required.
• Demonstrated proficiency with Microsoft Office applications, including Outlook, Teams, Word, and Excel
• Experience with MedTrainer Credentialing software preferred

COMPETENCIES:
• Strong Organizational Skills
• Customer Service Skills
• Accountability
• Cross-Functional Collaboration
• Managed Care Contract Knowledge
• Professional Integrity

PHYSICAL DEMANDS AND WORK ENVIRONMENT (per ADA guidelines):
• Physical Demands:
     o Sedentary work requiring prolonged periods of sitting at a computer workstation
     o Regular use of hands and fingers for keyboarding and other standard office equipment
     o Ability to communicate effectively through verbal and written means
     o Ability to hear and understand spoken information in-person and via electronic means
     o Visual acuity to ensure the accuracy of work performed on screens and in documents
     o Ability to maintain focus and attention to detail for extended periods
• Work Environment: This position is based in a professional office and/or remote office setting that consists of a climate-controlled indoor environment with standard office noise levels that utilizes computers, phones, and related technology.
• Reasonable accommodations may be provided to qualified individuals with disabilities to enable performance of essential job functions, in accordance with applicable laws.