Provider Enrollment Specialist

Overview

To perform the process of provider and group enrollment for the ARH system to include but not be limited to individual providers, clinics and hospitals.

• Preparing enrollment applications for various insurance payers for individual providers, hospitals and clinics as well as other related entities.
• Communicating with representatives from insurance payers on the status of applications in process or other provider enrollment issues.
• Preparing rosters with provider and group information as needed.
• Communicating with clinic managers, and other hospital and clinic staff regarding the enrollment process and information that may be needed.
• Understand specific application requirements for each payer including pre-requisites, forms required, form completion requirements, supporting documentation (DEA, CV, etc.), and regulations.
• Maintain documentation and reporting regarding provider enrollments in process.
• Retain records related to completed provider enrollments.
• Perform other duties as assigned.

Education

Associate Degree preferred. High School Diploma required.

Minimum Work Experience

Experience in the area(s) of provider enrollment, credentialing or billing is preferred.

Required Skills, Knowledge, and Abilities

• Must be proficient in Windows, Word, Excel and other computer skills.
• Must be detail oriented and thorough in order to ensure the complex enrollment packages are complete and correct.
• Must be able to communicate well with a wide variety of contacts at all levels of the organization.
• Maintains strict confidentiality with regard to protected health information and provider information.