Provider Credentialing Specialist II - REMOTE

US Anesthesia Partners, Inc. • Full-time • Remote (US) • 3m ago

Overview

Provides direct enrollment support to clinical providers to achieve desired enrollment effective dates with payers and maintains provider enrollments throughout the provider’s tenure with USAP to receive optimal reimbursement from payers.

At this time, US Anesthesia Partners does not hire candidates residing in California, Hawaii, or Alaska.

The base pay estimate for this role is $18.17 - $29.04 hourly. The final offer will depend on the skills, experience, and qualifications of the selected candidate. This range is for base pay only and does not include bonuses or other compensation. This position is eligible for a quarterly bonus. Bonuses are not guaranteed and are awarded based on company and individual performance.

Job Highlights

ESSENTIAL DUTIES AND RESPONSIBILITIES: (The ideal candidate must be able to complete all physical requirements of the job with or without a reasonable accommodation)

Submits and processes initial enrollment applications and re-enrollment applications to payers in multiple states as assigned by leadership.
Maintains the accuracy of provider NPPES and CAQH accounts.
Populates and prepares enrollment applications for providers.
Responsible for following up on outstanding enrollment information and/or paperwork from providers.
Reviews provider applications for accuracy and completeness.
Tracks and follows up on enrollment or re-enrollment applications with payers until provider enrollment or re-enrollment is completed.
Responsible for provider file maintenance with the payers, including but not limited to provider name changes, license updates, required attestations, and any other payer required data.
Works reports that identify enrollment issues distributed by leadership.
Completes reports provided by leadership by assigned deadlines.
Demonstrates exemplary customer service to our payers, providers, and other USAP employees.
Meets targeted enrollment deadlines.
Communicates risk to leadership as soon as identified.
Consistently meets USAP set work standards.
Proficiently uses the USAP credentialing system as instructed by leadership.
Maintains the USAP credentialing database as it pertains to enrollment.
Contributes to the advancement and growth of the department.
Performs other duties as requested.

Qualifications

KNOWLEDGE/SKILLS/ABILITIES (KSAs):

High School graduate or equivalent. AS or B.S. degree in business administration or health care related field is a plus.
Previous enrollment experience with, but not limited to, Medicare, Colorado Medicaid, and Kansas Medicaid is preferred, but not required.
Knowledge of organization’s policies, procedures and systems.
Have a working knowledge of the enrollment process and requirements.
Knowledge of Medicare and Medicaid enrollment standards.
Knowledgeable with NPPES website and NPI accounts.
Skilled in computer applications including MS Word, MS Excel, database administration and scanning applications.
Have excellent customer service skills.
Have strong organizational and time management skills.
Ability to be flexible to change and growth.
Ability to work effectively in a fast paced, high volume environment.
Demonstrate ethical problem-solving skills.
Skilled in professional verbal, written and email communications.
Ability to work effectively with staff, physicians and external customers.
Ability to work independently with limited supervision.
Communicate professionally with the public.
Ability to independently and consistently execute job responsibilities within a reasonable timeframe.
Ability to read, write, and speak English.

*The physical demands described here are representative of those that may need to be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Occasional Standing
Occasional Walking
Frequent Sitting
Frequent hand, finger movement
Use office equipment (in office or remote)
Communicate verbally and in writing

US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factors.

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