Days, Monday - Friday 8AM-4:30PM
Remote (Must Live in OH - Onsite depending on business needs required)
Summary
The Managed Care Provider Enrollment Specialist coordinates the provider enrollment process for the hospital's employed physicians and others to obtain participation status with managed care organizations [MCOs] and governmental agencies under contract with the hospital.
Responsibilities
- Coordinates the provider enrollment process for the hospital's employed physicians and others to obtain participation status with managed care organizations [MCOs] and governmental agencies under contract with the hospital.
- Maintains ongoing communication with MCOs and governmental agencies and employed providers' offices to update provider information, troubleshoot and problem solve regarding provider participation issues.
- Develops, maintains and uses applicable databases to support accurate and timely enrollment reporting.
- Promotes positive relationships between hospital, MCOs, governmental agencies, and referring physicians through internal and external communication regarding providers' participation status.
- Works independently and completes special tasks as assigned.
- Other duties as required.
Technical Expertise
- Experience in managed care provider credentialing or enrollment and provider relations is preferred.
- Experience in customer service is required.
- Experience working with all levels within an organization is required.
- Experience in healthcare is preferred.
- Proficiency in MS Office [Outlook, Excel, Word] or similar software is required. Database management software is required.
- Education: High School Diploma or equivalent required. Bachelors preferred.
- Certification: None.
- Years of relevant experience: 0 to 2 years is preferred.
- Years of experience supervising: None.
FTE: 1.000000
Status: Remote
