Provider Enrollment Specialist

 Posted 3 days ago
     
2-5 years experience
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AI Summary

Manage provider and facility payer enrollment applications from preparation through completion while ensuring accuracy and regulatory compliance. Monitor pending applications, resolve enrollment issues, and maintain accurate information across various credentialing databases and payer portals.

Bridgeview Eye Partners is seeking a detail-oriented and highly organized Provider Enrollment Specialist to join our Credentialing team. In this role, you’ll play an important part in ensuring our providers and facilities are successfully enrolled with government, managed care, and commercial payers so our patients can continue to receive exceptional eye care without interruption.

If you enjoy managing details, solving problems, working across departments, and keeping complex processes moving forward, this could be a great opportunity for you.

What You’ll Do

  • Manage provider and facility payer enrollment applications from preparation through completion, ensuring accuracy and timely submission.
  • Collect, review, and verify documentation required for provider and facility enrollments.
  • Complete payer enrollment, hospital credentialing, professional licensure, and related applications in accordance with payer requirements and government regulations.
  • Maintain accurate information across credentialing and enrollment databases and payer portals, including Availity, CAQH, NaviNet, NPPES, and PECOS.
  • Monitor pending applications, identify deficiencies, and work proactively to resolve issues and keep enrollments on track.
  • Research and resolve provider and facility enrollment issues by partnering with internal teams and external payer contacts.
  • Monitor revalidations, license renewals, and other required updates to ensure providers remain compliant and enrolled.
  • Support the Credentialing Manager with new facilities, locations, and providers as Bridgeview Eye Partners continues to expand into new markets.
  • Escalate complex or unresolved credentialing and enrollment issues appropriately.
  • Provide responsive, professional support to internal stakeholders throughout the enrollment process.

What We Offer

  • Competitive hourly wage 
  • Paid holidays + 2 Floating Holidays
  • Approximately 10 days of PTO within first year
  • Benefits including medical, dental, & vision
  • 401(k)

What We’re Looking For

Required:

  • High school diploma or equivalent.
  • At least 3 years of healthcare experience in payer relations, market access, managed care, provider enrollment, credentialing, or a related field.
  • Strong organizational skills and exceptional attention to detail.
  • Proficiency with Microsoft Office, including Outlook, Teams, Word, and Excel.
  • Ability to manage multiple priorities, meet deadlines, and maintain accuracy in a highly detail-oriented environment.
  • Strong communication and customer service skills.
  • Demonstrated accountability, professionalism, and integrity.

Preferred:

  • Bachelor’s degree in Business, Healthcare Administration, or a related field.
  • Experience with MedTrainer Credentialing software.
  • Knowledge of managed care contracts and payer requirements.

Why This Role Matters

Provider enrollment is a critical part of healthcare operations. Your work will help ensure our physicians and other providers are properly enrolled, credentialed, and ready to serve patients across our growing organization.

You’ll collaborate with teams throughout the organization, work with a variety of payers and regulatory systems, and have the opportunity to make a meaningful impact behind the scenes in the delivery of quality patient care.

Position Details

This is a non-exempt role, reporting to the Credentialing Manager, and working in a professional office or remote office environment.

This is primarily a sedentary, computer-based role requiring extended periods of sitting, keyboarding, visual attention to detail, and effective written and verbal communication. Reasonable accommodations may be provided to qualified individuals with disabilities in accordance with applicable law.

 

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