Job Type
Full-time
Description
Job Summary:
The Provider Enrollment Specialist coordinates all aspects of the credentialing and re-credentialing process for ADVOCATE clients. They will be responsible for ensuring accuracy and completeness of all documentation in accordance to state and federal requirements. This position is open to either working fully remotely or on a hybrid schedule out of our Dublin, OH office.
Why Work for Advocate?
- Great benefits beginning day one to include Medical/Dental/Vision
- HSA, FSA, and Dependent Care FSA options are available
- HSA Wellness Program with $600 employer contribution
- Annual biometric screenings
- Company swag on day one
- Employee appreciation days
- 401k with employer match: 100% on the first 3%, 50% on the next 2%
- A culture of promotion from within
- PTO and sick time
- Ten paid holidays including the day after Thanksgiving and Christmas Eve
- Consistent Monday through Friday schedule
- Referral bonuses
- Potential for hybrid work schedule
- Parental leave
- Employer-paid short/long-term disability and Life/AD&D
- Employee of the Month bonuses
- Voted one of the 2022 Top Places to Work in Columbus by Columbus CEO Magazine!
Essential Job Functions:
- Facilitates initial appointment, re-appointment and tracking of expired documents.
- Reviews provider credentialing applications for completeness, accuracy, and compliance with current credentialing guidelines, NCQA, state, and federal requirements.
- Reviews and performs primary source verification of all applicant licensure, education and training, relevant employment history, and affiliations; assesses risk exposure during and at the time of recredentialing.
- Responsible for the accuracy and integrity of the credentialing database system and related applications.
- Works with payors to ensure proper enrollment for billing and payment receipt.
- Performs other related duties as assigned.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. Management maintains the right to assign or reassign duties and responsibilities to this job at any time.
Requirements
Required Skills:
- Excellent verbal and written communication skills.
- Proficient in Microsoft Office Suite and proprietary database applications.
- Ability to use independent judgment and to manage and impart confidential information.
- Ability to multi-task and manage priorities and meet critical deadlines.
- Ability to work independently and in a fast-paced environment.
- High level of awareness of pertinent details; excellent organizational skills.
Education and Experience:
- High school diploma or equivalent required.
- One to two years credentialing and provider experience preferred.
- At least one year of medical billing experience preferred.
Physical Demands and Physical Work Environment:
- In-Office/Hybrid Employee
- Physical Demands: This role routinely uses standard office equipment such as computers, typing, looking at computer screens, inbound and outbound phone/video calls, photocopiers, filing cabinets, and fax/scan machines. Sitting for long periods of time, walking to and from different areas of the building, pushing/pulling/lifting/carrying up to 10 pounds, etc.
- Physical Work Environment: This job operates in a professional office environment. The parking lot for the building is large and walking is required to approach and enter the building lobby. The office is located on the third floor and is accessible through the building lobby via elevator or stairs. To enter into and maneuver around the office, doors up to 10 pounds must be either pushed or pulled.
- Remote Employee
- Physical Demands: This role is largely sedentary and requires long periods of time sitting, typing, looking at computer screens, inbound and outbound phone/video calls, other standard office equipment, etc.
- Physical Work Environment: This role is fully remote which means the individual will work from their own home.
EEO Statement:
ADVOCATE Revenue Cycle Management does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor.
Eligible States
Currently only accepting candidates located in AL, CA, CT, FL, GA, ID, IL, IN, KY, LA, ME, MS, MO, NE, NH, NJ, NM, NY, NC, OH, PA, RI, SC, TN, TX, VA or WV.
