Provider Enrollment Specialist - Corporate

Job Description

Job Description

About Us:

TeleSpecialists is transforming healthcare delivery as the nation's largest and fastest-growing digital healthcare leader. By providing expert neurological and psychiatric care directly to over 400 hospitals and health systems across the country, we don't just provide care; we pioneer solutions that make quality healthcare easily accessible.

Join a team where your passion meets our purpose. If you’re inspired by innovation, thrive in a collaborative and entrepreneurial environment, and want to be a part of a team that’s reshaping the future of patient care, we want you on our team. At TeleSpecialists, you'll discover more than just a job. You will be able to experience meaningful work, accelerated career growth, and the opportunity to redefine healthcare for the future.

Tele Specialists Offers:

• A great culture with a team environment
• A fun, diverse work environment
• A rapidly growing company with career advancement opportunities
• Medical, Dental and Vision benefits
• 401k match
• Paid Vacation
• Leadership Training Classes
• Mentorship Program
• Tuition Reimbursement

Position Summary:

The Payer Enrollment Team Member is responsible for assisting facilities with enrolling TeleSpecialists providers with Medicare, state Medicaid and commercial insurance carriers. The Payer Enrollment Team Member is responsible for maintaining current CAQH, PECOS and State Medicaid profiles. The Payer Enrollment Team Member also ensures that management is made aware of any issues with the provider profiles.

Essential Duties and Responsibilities:

• Complete initial, reassignment and re-validation applications with Medicare for facilities and providers.
• Complete initial, reassignment and re-validation applications with various state Medicaid’s for facilities and providers.
• Ensure physician Medicare re-validation apps for Commercial insurance networks are completed on time.
• Maintain PECOS portal for providers, including approval of facilities and updating demographic information.
• Manage and Maintain NPPES portal for providers.
• Create, update, and maintain CAQH profiles for providers.
• Manage Practice Manager CAQH profile for all providers and facilities.
• Manage password updates for various enrollment portals, included but not limited to CAQH, Medicare and Medicaid.
• Updating and maintaining MD Staff with the progress of all activities.
• Complete facility payer enrollment paperwork for providers and return to the facility in a timely manner.
• Manage Availity portal for various insurance networks.
• Other duties as assigned.

Education/Experience:

• Payer Enrollment experience required.
• Credentialing software experience required; MD Staff preferred.
• Experience with Joint Commission or National Committee for Quality Assurance preferred.