Provider Enrollment Specialist

EyeCare Partners is the nations leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a lifetime of care to our patients with a mission to enhance vision, advance eye care and improve lives. Based in St. Louis, Missouri, over 650 ECP-affiliated practice locations provide care in 18 states and 80 markets, providing services that span the eye care continuum. For more information, visit click to view www.eyecare-partners.com .

Job Title: Provider Enrollment Specialist

Job Summary

Our growing eye care organization has an immediate need for an experienced Provider Enrollment Specialist who is familiar with provider data management and credentialing. A successful individual in this role will manage multiple enrollments and priorities while providing support to the Supervisor of Provider Enrollment.

Duties and Responsibilities

Serve as the first point of contact for internal office and provider requests.

Keep all provider enrollment data up-to-date and current.

Complete re-credentialing paperwork as needed.

Keep all internal enrollment tracking methods up to date.

Detailed understanding of Medicare, Medicaid, and Managed Care Plan regulations

Keep CAQH and NPPES updated with accurate and current information.

Maintain constant contact with insurance payer representatives.

Communicate enrollment updates and issues to leadership.

Follow up with payers on outstanding enrollments on a weekly basis.

Maintain all demographic changes for all providers.

Maintain all hospital appointments and re-appointments.

Performs other duties that may be necessary or in the best interest of the organization

Education:

High School Diploma or GED Required

Experience Requirements

2+ years of related experience or training, equivalent combination of education and experience will be considered

Knowledge, Skills and Abilities Requirements

Professional in appearance and actions

Logical and Critical thinking skills for problem solving and analysis.

In-depth knowledge of performance metrics

Customer-focused with excellent written, listening and verbal communication skills

Ability to maintain control of a call de-escalating issues and instilling confidence that a resolution will be found

Ability to function effectively under stress of conflicting demands on time and attention, while successfully meeting deadlines

Enjoys learning new technologies and systems Detail oriented, professional attitude, reliable

Exhibits a positive attitude and is flexible in accepting work assignments and priorities

Meets attendance and tardiness expectations, ability to work overtime, if required.

Management and organizational skills to support the leadership of this function

Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations

Interpersonal skills to support customer service, functional, and teammate support need

• Able to communicate effectively in English, both verbally and in writing

Ability for basic to intermediate problem solving, including mathematics

Intermediate computer operation

• Proficiency with Microsoft Excel, Word, PowerPoint and Outlook

Specialty knowledge of systems relating to job function

Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines

Job descriptions are intended to be accurate reflections of those principal job elements essential for making fair pay decisions about jobs. Nothing in this job description restricts management right to assign or reassign duties and responsibilities to this job at any time.

Physical Requirements:

While performing the duties of this job, the employee is regularly required to talk and hear. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee must frequently lift and/or move up to 10 pounds.

Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

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EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Please do not contact the office directly only resumes submitted through this website will be considered.