Virtual Hiring: Healthcare Enrollment & Credentialing Specialist | Remote ID-3417

Position Summary

The Enrollment Specialist is responsible for creating, managing and maintaining all company-wide enrollment activity. The Enrollment Specialist will coordinate and communicate with the Providers and Payers to ensure that all enrollment requirements are fulfilled and successfully transition individual Providers to electronic claims submission.

Essential Job Duties and Responsibilities:

  • Create internal enrollment documents and continually ensure that they are up to date with Payer requirements and documentation
  • Continually update Payer Manager on status and/or updates
  • Follow-up on pending applications with Payers and transmit external notices to Providers
  • Coordinate with Providers to confirm that proper enrollment activity activities are followed based on individual Payer requirements
  • Process all fax and email enrollment requests timely
  • Document and review all enrollment packages prior to transmitting them to Payer for accuracy and completeness
  • Maintain all enrollment forms and ensure that they are kept up to date
  • Coordinate actions/activities with other departments when a provider is approved for electronic submission
  • Disseminate internal notices to ensure that all departments are aware of any changes in enrollment
  • Systematically send reports to direct supervisor on updates in enrollment
  • Must continually stay knowledgeable about the products and services that we offer
  • Must maintain appropriate confidentiality in working with sensitive data/information
  • Consistently meet company and department policies and expectations including those surrounding attendance.
  • Comply with all federal, state, accreditation and institutional policies and procedures
  • Maintain confidentiality standards and expectations
  • Exhibit exceptional internal and external customer service with all individuals
  • Observe security responsibilities including, but not limited to:
  • Utilize appropriate communication channels for the movement of data
  • Use minimum data necessary to identify transactions. Claim ID, Claim File Upload ID, ERA Trace Number/Check ID. Only when those identities are not enough for the recipient to find the transaction, then use the minimum PHI needed to identify the transaction
  • Security is everyone’s job. Look out for, and report, anything that is suspicious or just doesn’t seem correct.
  • Other duties as assigned

Key Success Factors:

  • Consistently meets and/or exceeds enrollment goals and expectations
  • Creates clear and thorough documentation/documents as per guidelines
  • Successfully support Providers and Payers adapting to different client needs and expectations with efforts resulting in consistently positive feedback from clients
  • Able to work effectively with other team members/departments to ensure the maximum results for our clients within the protocols established for the position
  • Observes and maintains positive relationships both internally and externally
  • Accurate and thorough documentation as per position expectations and our protocols
  • Able to communicate successfully with clients and internal associates with consistently positive feedback
  • Regularly meets the productivity and accuracy requirements established

Education, Experience and Skillset:

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  • Associate degree or equivalent experience preferred
  • Prior experience in the Dental industry helpful
  • Excellent analytical, organizational, and time management skills
  • Ability to effectively manage time and prioritize
  • Strong multi-tasking skills and able to adapt to changing expectations and priorities
  • Able to exercise a high level of tact and discretion in both internal and external interactions
  • Strong written and verbal communication and interpersonal skills
  • Proficient in all MS-Office Applications and use of the Internet
  • Key attention to detail and accuracy
  • Ability to work closely with other employees with patience and flexibility to take on new tasks

Requirements:

  • Call Center/BPO Experience is a must
  • Willing to work on shifting schedules, graveyard shift, holidays and weekends if required.
  • Candidate residing in Manila or nearby provinces is preferred.
  • Stable internet connection not less than 35mbps
  • Dedicated workspace suitable for remote work
  • Can start ASAP. This is an urgent hiring.

Additional Benefits:

  • Flexible work arrangement – work from home
  • Equipment is provided
  • 13th Month Pay
  • Transportation Allowance
  • HMO (medical and dental coverage)

Virtual Hiring: Healthcare Enrollment & Credentialing Specialist | Remote ID-3417