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Provider Enrollment Specialist

PursueCare

PursueCare

This job is no longer accepting applications

See open jobs at PursueCare.
Hartford, CT, USA
Posted on Tuesday, January 23, 2024
We are looking for an experienced, detail-oriented, organized, and driven Provider Enrollment Specialist. The ideal candidate will have significant expertise and ability to accurately and timely coordinate, facilitate, and complete payer enrollment applications, credentialing, and re-credentialing with contracted insurances. Experience in the substance use treatment setting is preferred.
What You’ll Do:
The Provider Enrollment Specialist will work directly with providers (addiction counselors, therapists, medication-assisted treatment physicians, and clinics) to expediate provider enrollment applications with Medicare, Medicaid, and other payers as needed. The Provider Enrollment Specialist will work closely with the operations and recruiting teams to ensure all departments are aware of expected timeframes for enrollment completion and are aware of any delays in the process. The Provider Enrollment Specialist is also responsible for timely communication with payers and maintaining proper documentation for regulatory compliance and quality assurance purposes.
Specific hands-on and mission-critical initiatives may include:
  • Review new provider enrollment information to determine all issues that need to be addressed.
  • Maintain provider information via provider enrollment software including demographics for all providers.
  • Maintain CAQH electronic database of provider information and credentials. Work with enrolled providers to ensure ongoing attestations are completed in a timely manner.
  • Process provider enrollment applications with Medicare, Medicaid, commercial payers, and other payers as needed for maximum reimbursement of services rendered.
  • Continually follow up with payers to ensure timely enrollment and participation, including revalidation dates.
  • Respond to internal and external inquiries on routine enrollment matters, as appropriate.
  • Update and track all systems for enrollment progression for transparency between all departments.
  • Proactively address /escalate any concerns/problems to management.
  • Maintain and update all provider licenses for renewals and compliance.
  • Work collaboratively throughout the organization in an advisory capacity to meet enrollment and PAR goals & objectives. Suggest and implement continuous quality & process improvement solutions and provide collaborative, high-quality service.
We’re Looking For:
  • High School diploma or GED required. Associates degree is preferred.
  • A minimum of 5 years provider enrollment experience is required. Experience in substance use treatment and/or behavioral health setting is preferred.
  • Medical billing experience is a plus.
  • Experience with CredentialStream Software is strongly preferred.
  • Excellent and thoughtful verbal and written communication skills
  • Excellent organizational skills
  • Drive to take ownership to meet professional obligations.
  • Ability to juggle and prioritize projects in a fast-paced and deadline-driven environment.
  • Desire to contribute wherever support is necessary.
  • Desire to learn and grow with our company - to put in the time, focus and effort necessary to advance to the next level of their career.
  • Work style, pace, and drive to make things happen, with a bias for initiating and driving positive results.
  • Belief that healthcare reform begins with innovation aimed at making people's lives better.
Where You’ll Work:
PursueCare is a startup technology-enabled healthcare management services organization ("MSO") that is addressing the opioid epidemic with an intelligent, convenient, and stigma-free telehealth treatment platform that creates a better experience and outcomes for healthcare providers and patients alike. As traditional opioid addiction treatment models have failed to provide enough access and lasting outcomes for patients, states continue to push for innovative solutions to serve the overwhelming need, particularly across rural and underserved areas. Our vision is to improve access to opioid addiction care and promote better patient engagement/outcomes by providing convenient, private and stigma-free telemedicine services through a virtual network of on-demand prescribing physicians, addiction counselors, and clinics, as well as other recovery resources and dedicated addiction pharmacy services, right through a browser or smart phone app.
Our platform offers telehealth video conferencing, marketing, care coordination, billing, EHR, reporting, partnerships with referral sources for patients in need of recovery intervention, and ancillary services to addiction treatment practitioners and clinics. We offer greater access and engagement with private, stigma-free medication-assisted treatment (“MAT”) programs and evidence-based protocols, increasing the likelihood practitioners will be able to treat more patients, more consistently, with better outcomes.
We offer all full-time employees unlimited paid time off to allow our team members to properly recharge, competitive salaries, bonus opportunities, equity opportunities, and affordable health coverage with company contributions. We are located in Middletown, CT which is coincidentally right smack in the middle of Connecticut. We offer work-from-home/remote opportunities for certain positions, based upon being able to meet the core competencies and requirements for the position from your location. We pledge to be an Equal Opportunity Employer.

htttps://www.pursuecare.com

This job is no longer accepting applications

See open jobs at PursueCare.