Provider Enrollment Specialist - Remote (OR, WA, AK) - PeaceHealth
Vancouver, WA 98661
About the Job
**Description**
**PeaceHealth is seeking a Provider Enrollment Specialist - Remote for a Full Time, 1.00 FTE, Day position.** The salary range for this job opening at PeaceHealth is $22.70 - $34.04. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.
**MUST LIVE IN THE STATES OF OREGON, WASHINGTON OR ALASKA.**
**Job Summary**
Coordinates provider enrollment service processes for governmental and non-delegated third-party payers for Providers associated with PeaceHealth. Coordinates new department builds, new clinics, applying for NPI's and applying to add new locations to all health plans.
**Details of the position**
+ Prepares and submits applications for new providers and submits them to PeaceHealth contracted payors and government health plans for the appropriate state.
+ Communicates and follows up with providers regarding new provider enrollment, licensing, and DEA requirements for new providers and any changes in location or status of providers, issues and questions.
+ Prepares and tracks provider revalidation and recredentialing applications.
+ Tracks provider payor approvals.
+ Builds a knowledge base for payer requirements and governmental payers regulations.
+ Develops working knowledge of payor policies and licensing process for multiple states.
+ Offers troubleshooting assistance to all internal departments to solve issues and with providers to complete required enrollment items.
+ Maintains OneHealthPort, Provider Source, CAQH, PECOS and NPPES data bases. Maintains CredentialStream for all non-delegated provider types.
+ Completes research for denied claims so PFS can release claims for reimbursement.
+ Performs other duties as assigned.
**What you bring**
**Education**
+ High School Diploma Required: or equivalent
+ Associate Degree Preferred: or
+ Bachelor's Degree Preferred.
**Experience**
+ Minimum of 2 years Required: Experience in provider enrollment or equivalent combination of relevant experience, skills, abilities and education may be acceptable and
+ Preferred: Medical terminology and
+ Required: Thorough knowledge of CMS (Centers for Medicaid and Medicare Services) and other applicable guidelines and regulations and
+ Preferred: Experience with Verity database or other credentialing databases and
+ Preferred: Experience with OneHealthPort, Provider Source, CAQH, payer sites
**Skills**
+ Excellent verbal and written communication skills, including knowledge of communication concepts and organizational strategies, particularly as it applies to provider enrollment. (Required)
+ Strong organizational and analytical skills. (Required)
+ Ability to meet time-sensitive deadlines. (Required)
+ Ability to manage multiple priorities, projects and display flexibility in a fast paced and changing work environment. (Required)
+ Detail oriented with demonstrated organizational ability. (Required)
+ Proficient computer skills in Windows, Microsoft Word, Access, Excel and PowerPoint. (Preferred)
**Working Conditions**
**Lifting**
+ Consistently operates computer and other office equipment.
+ Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.
+ Sedentary work.
**Environmental Conditions**
+ Predominantly operates in an office environment.
+ Some time spent on site in medical/hospital setting.
**Mental/Visual**
+ Ability to communicate and exchange accurate information.
+ The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.
PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.
See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility (https://www.thecaregiver.org/wp-content/uploads/2017/05/PeaceHealth-Statement-of-Commitment-to-Diversity-and-Inclusion-vFINAL.pdf) .
For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.
**PeaceHealth requires a completed Primary Vaccine Series (e.g., 2 dose monovalent Pfizer, Moderna or Novavax series or 1 dose J&J vaccine series) or be Up to Date (receiving the most recent Pfizer/Moderna bivalent vaccine/booster) for COVID-19 vaccination prior to their start date. PeaceHealth has a medical and religious exemption request process for those that are unable to receive the COVID-19 primary vaccine series due to medical/religious reasons. For caregivers that will be working in Oregon there is a personal vaccine exemption form that may be requested.**
REQNUMBER: 94859
Source : PeaceHealth