Exciting News, Advocate RCM is growing! We are adding multiple positions to our team, including this Provider Enrollment Specialist role! We look forward to your application.
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.
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.
- 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, college degree preferred.
- One to two years credentialing and provider experience preferred.
- At least one year of medical billing experience preferred.
Physical Demands: This is largely a sedentary role. This would require the ability to move files and paperwork, open filing cabinets and bend or stand as necessary.
Work Environment: This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
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.