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Anders · 3 days ago

Provider Enrollment Specialist

St. Louis, MO

Full-time

Hybrid

Mid Level

$21/hr - $27/hr

3+ years exp

A5 Healthcare, an Anders Affiliate, is one of the fastest-growing Credentialing Verification Organizations in the country, seeking a Provider Enrollment Specialist. This role focuses on ensuring seamless enrollment of healthcare providers while adhering to accreditation standards and involves processing applications, maintaining records, and effective communication with providers and internal staff.

Accounting

No H1B

Responsibilities

Process and submit initial provider applications, revalidations, and renewal applications in compliance with NCQA, URAC, and CMS accreditation standards

Perform thorough and accurate data entry and verification of provider information into credentialing databases

Conduct timely follow-up on missing or incomplete information with the provider, client, or team lead responsible for a provider file to ensure prompt and efficient provider enrollment

Assist in the preparation and submission of required documentation for provider enrollment and credentialing to include delegation rosters

Coordinate with internal staff and external entities to resolve issues related to provider enrollment and credentialing

Monitor and track the status of provider applications, payer directories, conducting regular follow-up with health plans until verification of completion is received from each payor

Support the enrollment and delegation team with various tasks as needed

Qualification

Data entryHealthcare regulationsNCQA standardsURAC standardsCMS standardsOrganizational skillsCommunication skillsProblem-solving skillsTeamworkAttention to detail