Senior Pharmacy Provider Enrollment Specialist

Walgreens; Danville (IL); On-site; USD 21,000 - 41,000; Full time

Job summary

Walgreens is seeking a Senior Specialist, HAR Provider Enrollment to manage provider enrollment processes, ensure compliance, and maintain strong client relationships. You will handle initial and renewal applications for billing at federal, state, and commercial levels, and support pharmacy operations with timely, accurate processing.

Responsibilities include state Medicaid enrollment, demographic updates, escalation handling, and collaboration across teams to improve enrollment workflows while

Qualifications

• High School Diploma or GED plus at least 1 year in an office or customer service.
• Proficient in MS Windows and basic PC skills.
• Experience with Microsoft Word, Excel, and Access.
• Experience providing customer service to internal and external customers.
• Excellent verbal and written communications.

Responsibilities

• Processes, either on paper or online, all pharmacy enrollment applications accurately, completely, and timely to support pharmacy operations.
• Serve as a subject matter expert related to the enrollments of their assigned state Medicaids.
• Research applicable enrollment or participation rules and regulations within each state funded programs, not limited to Medicaids, for changes.
• Maintain current pharmacy demographic, ownership, and managing employee/officer information on file with NCPDP, NPPES, and the various state and governmental payers and DMEPOS Accreditation vendor.
• Processes, either on paper or online, all SNAP and WIC enrollment applications accurately, completely, and timely to support operations.
• Serves as first escalation point for enrollment problem resolution.
• Investigate, troubleshoot, and solve operational issues as it relates to being a recognized billing provider.
• Applies Walgreens policies in the security of personal information and the internal Legal guidance for credentialing responses.
• Obtains and maintains governmental portal web access for enrollments, prior auths, claim status, and remittance detail for pharmacy personnel and HAR team members.
• Coordinates with other functional and operational areas as necessary
• Contacts state Medicaid offices or processors for clarification or issue resolution
• Cultivates an innovation mindset to improve processes within regulatory framework
• Assist in training and mentoring new Provider Enrollment Coordinators
• Plans, prioritizes, organizes and completes work to meet objectives/SLAs/Timelines
• Monitors trends and notifies supervisor of recurring or high priority issues.

Skills

Customer service

Communication

Data entry

Attention to detail

Education

High School Diploma or GED

Bachelor's degree

Tools

Microsoft Word

Microsoft Excel

Microsoft Access

Job description

Walgreens is seeking a Senior Specialist, HAR Provider Enrollment to manage provider enrollment processes, ensure compliance, and maintain strong client relationships. You will handle initial and renewal applications for billing at federal, state, and commercial levels, and support pharmacy operations with timely, accurate processing.

Responsibilities include state Medicaid enrollment, demographic updates, escalation handling, and collaboration across teams to improve enrollment workflows while