Provider Enrollment Associate

Geode-Health; United States; Hybrid; USD 32,000 - 34,000; Full time

Benefits offered by this job

Competitive compensation

Flexible schedule

Medical, dental and vision benefits

Life insurance

Short and long-term disability

Paid vacation and holidays

Matching 401k plan

Professional development

Job summary

Geode Health is hiring a Provider Enrollment Associate to oversee credentialing, licensure, and payer enrollment for clinicians across the United States.

You will collaborate with providers and third-party partners to ensure timely enrollment actions, maintain accurate provider data, and report on processing delays while driving improvements in enrollment timelines.

Qualifications

• Experience with credentialing, licensure, and payer enrollment processes.
• Regularly updating provider databases with accurate licensure and enrollment details.

Responsibilities

• Act as liaison to providers and vendors to obtain information for credentialing, licensure and enrollment in a timely manner.
• Provide credentialing and enrollment expertise to the organization.
• Develop knowledge base through regular meetings and coaching of staff.
• Maintain accuracy of provider databases including payer enrollment, licensure and malpractice information.
• Provide regular reporting of delays in credentialing or enrollment processes.
• Investigate and address issues, implement solutions to mitigate risk and reduce timelines.
• Assist in resolving payer enrollment related claim denials.
• Monitor KPIs for credentialing, licensure and enrollment tasks.

Skills

Credentialing

Licensure verification

Payer enrollment

Communication skills

Organization

Customer service

Education

Associate degree

Bachelor’s degree preferred

Tools

PECOS

CAQH

Availity

EDI enrollment

ERA

EFT enrollment

Job description

Geode Health is a rapidly growing, national provider of outpatient mental health services. Our Mission is to “Transform mental health by making it more accessible, affordable and effective”.Reporting to Credentialing Manager, the Provider Enrollment Associate is responsible for overseeing all credentialing, licensing, and payer enrollment tasks. The associate will work with providers and third-party partners to ensure all payer enrollment actions are completed in a timely manner while focusing on reducing overall enrollment related timelines. The Provider Enrollment Associate must be able to effectively communicate with providers and other internal/external customers.Estimated Pay Range: $23 - 25/hourJob Responsibilities:Act as a liaison to providers as well as any vendors to ensure all information required for credentialing, license verification and payer enrollment is obtained in a timely mannerProvide credentialing and enrollment expertise for the organizationLeverage expertise to develop third-party workers’ knowledge base through regular meetings and coachingMaintain accuracy of provider database including payer enrollment, licensure, and malpractice informationProvide regular reporting of any delays in credentialing or enrollment processesResponsible for investigating and self-reporting issues, developing and implementing solutions to address existing issues and identifying processes to mitigate riskAssists in resolving payer enrollment related claim denialsContinually monitor processes and outcomes to ensure established KPI’s for credentialing, licensure and enrollment tasks are metProvide feedback to Payer Contracting to ensure payer specific requirements are not only met, but optimized to reduce enrollment timelinesAbility to learn and document regulations and rules for new statesOther duties as assignedIdeal Candidate Profile:Passionate about our mission and inspiring othersOrganized & process-orientedCustomer service experience is preferredExcellent communication skills, both verbal and writtenSelf-starter, for whom no task is too big or too small and takes ownership of their decisionsContributes to the collective effort both within own scope - and beyond - as neededCreative and strategic thinker, who will dig for answersA lifelong learner who believes in giving and receiving feedback to get better each dayQualifications/Skills:In-depth knowledge of credentialing, licensure, and payer enrollment requirementsExperience using PECOS, CAQH, Availity and other payer portalsExperience with EDI, ERA & EFT enrollmentsProficient with MS Excel and PowerPointEducation and Experience Requirements:Associate degree or equivalent experience required; Bachelor’s Degree preferred.3-5 years’ experience working in provider enrollmentAt Geode Health, we offer:Competitive compensationMedical, dental and vision benefitsLife insuranceShort and long-term disabilityPaid vacation and holidaysMatching 401k planState of the art technologyWhy work for Geode Health?At Geode Health, we take our commitment to patients and providers seriously. We focus every day on how to help patients across the United States get the best possible mental health care available. To achieve this, we focus on ensuring our providers have unmatched support and resources so that they can focus on providing great care. We are backed by KKR, a leading private equity firm with the experience and mission alignment to truly make an impact. Joining Geode Health will put you on the front-end of a rapidly growing movement to increase access and improve outcomes for mental health patients and providers across the nation.To learn more, visit us as www.geodehealth.comAt Geode Health, we offer:Competitive compensationFlexible scheduleIn-person and virtual patient visitsComprehensive admin support (front office, accounting, finance, payroll, HR, etc)Professional development opportunitiesClinical community, support, and leadershipMedical, dental and vision benefitsLife insuranceShort and long-term disabilityPaid vacation and holidaysMatching 401k planState of the art technologyWhy work for Geode Health?At Geode Health, we take our commitment to patients and providers seriously. We focus every day on how to help patients across the United States get the best possible mental health care available. To achieve this, we focus on ensuring our providers have unmatched support and resources so that they can focus on providing great care. We are backed by KKR, a leading private equity firm with the experience and mission alignment to truly make an impact. Joining Geode Health will put you on the front-end of a rapidly growing movement to increase access and improve outcomes for mental health patients and providers across the nation.To learn more, visit us as www.geodehealth.comGeode Health is an Equal Opportunity Employer. We respect and seek to empower each individual and support the diverse cultures, perspectives, skills and experiences of our workforce.Estimated hourly pay range:$23.00-$25.00