Remote Health Plan Enrollment & Credentialing Specialist

symplr; United States; Remote; USD 28,000 - 33,000; Full time

Job summary

Symplr is seeking a PES Account Specialist to guide provider enrollment into Federal, State, and commercial plans. This remote role involves collecting provider data, completing enrollment applications, and following up with health plans until enrollment is finalized.

You will advise provider offices on best practices, maintain enrollment records in our software, and communicate clearly with plan contacts to resolve issues and keep numbers issued on schedule.

Qualifications

• Bachelor's degree required or desired.
• 2+ years in Payor/Provider Enrollment or Credentialing.
• Experience with Microsoft Office Suite including Word, PowerPoint, and Excel.

Responsibilities

• Communicate & advise the provider or designated contact person of the paperwork necessary to begin the enrollment process for new providers, explaining timeline expectations.
• Research payer requirements to gather all details to appropriately enroll provider.
• Maintain contact with designated contact person to obtain application signatures and collect all required documents to include with the completed applications.
• Key all provider demographics & enrollment data into software system.
• Scan all related enrollment documents and applications into software system.
• Contact health plans to request provider enrollment application packages and/or required action for enrollment and continue follow-up with insurance plans by telephone or email until all provider numbers are issued.
• Prepare & distribute Payor Affiliation Reports and Status Notes to designated contact person(s) for each provider every 2-3 weeks in order to communicate the progress of approved provider numbers.
• Ability to interact positively in a team environment, demonstrating superior teamwork skills.
• Interacts professionally with Symplr staff and occasional interaction with outside organizations.
• Verbal and communication skills are required to resolve issues.
• Other duties as assigned

Skills

Teamwork

Attention to detail

Time management

Communication

Project management

Customer focus

Deadline management

Credentialing systems

Education

Bachelor's degree

Tools

Microsoft Office

Job description

Symplr is seeking a PES Account Specialist to guide provider enrollment into Federal, State, and commercial plans. This remote role involves collecting provider data, completing enrollment applications, and following up with health plans until enrollment is finalized.

You will advise provider offices on best practices, maintain enrollment records in our software, and communicate clearly with plan contacts to resolve issues and keep numbers issued on schedule.