Vivo Infusion Hiring for Provider Enrollment Specialist – Remote at Remote Full Time

JOB TITLE: Provider Enrollment Specialist

COMPENSATION: $25.00 – $30.00

BENEFITS: Medical, Dental, Vision, Life, 401K with Match, Bonus Eligible

EMPLOYMENT TYPE: Full Time

S TO: Manger, Provider Enrollment

FLSA Status: Non-Exempt

The Provider Enrollment Specialist will to the Manager, Provider Enrollment, within the managed care department. This position will work in conjunction with the managed care contracting, credentialing and provider enrollment staff at VIVO Infusion. This individual will be responsible for enrolling providers both Physician and Advanced Practice Providers with commercial and private payers as well as Medicare, Medicaid and managed government plans. This individual will be responsible for the efficient and timely process of new and existing provider applications with payers. Work directly with managed care staff to maintain compliance with regulatory agencies like ACHC, TJC as well as all contracted payers.

Responsibilities

• Must have in-depth and proven knowledge of managed care concepts, industry terms, contracting and provider enrollment life cycle
• Experience enrolling MD’s, DO’s and APP’s with commercial payers, Managed Medicare and Managed Medicaid plans
• Working knowledge of CAQH profile management, attestation and PECOS
• Ability to work independently and within a team to track, manage, escalate and resolve the entire provider enrollment process
• Ability to use credentialing software and platforms to track pending applications
• Maintain and build working knowledge of all payers, markets, contracted relationships, providers, provider types and necessary requirements to complete enrollment in a timely AND accurate fashion
• Develop strong relationships with clinical staff, payers and operations
• Confidence and experience handling escalation processes to achieve desired outcomes
• Ability to think outside the box and solve complex issues as it relates to the provider enrollment process
• In-depth knowledge of national and local payors and markets throughout the country that VIVO has a presence in.
• Ensure the appropriate processes are in place to monitor and maintain systematic and timely enrollment, contracting, and licensing efforts with various health plans and facilities throughout the United States.
• Maintain effectiveness when experiencing major changes in work responsibilities or environment; adjust effectively to working within changing priorities, processes, and requirements.
• Knowledge and understanding of provider relations as it relates to all aspects of contracting, enrollment, and licensure.
• Support other functional areas including managed care contracting, RCM, operations, and coordinate with internal teams to achieve desired outcomes

Qualifications

• 3+ years of experience enrolling providers with payers, government agencies and managed government plans
• Experience working with large payer or provider organization and managing multiple tasks and priorities
• Knowledge of credentialing, licensure requirements to complete necessary provider enrollment applications
• Strong knowledge of managed care contracting, credentialing & provider enrollment