Senior Provider Enrollment Representative

Davita Inc.; Village of Lake Success (NY); On-site; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare organization seeks a professional to guide the enrollment processes for faculty practice providers, ensuring accuracy and adherence to operational policies. The role requires a strong background in handling enrollment issues, excellent problem-solving skills, and relevant experience in a healthcare setting.

Qualifications

• 3-5 years of relevant experience required.
• Equivalent experience acceptable.

Responsibilities

• Guide the processing of problematic faculty practice provider enrollments.
• Initiate and track enrollment for new faculty practice providers.
• Resolve provider-related denials and rejections.

Skills

Attention to Detail

Problem Resolution

Communication

Education

Associate's Degree

Job description

Job Description

Guides the processing of faculty practice provider enrollment in accordance with operational policies and procedures. Initiates and processes faculty practice provider enrollments/re-enrollments including, but not limited to correspondence; resolving denials or rejections; ensuring proper payment; providing related information to Information Systems.

Job Responsibility

• Guides the processing of problematic faculty practice provider enrollments to ensure accuracy and completeness of the managed care/government applications.


• Initiates and tracks enrollment and re-enrollment for high priority and new faculty practice providers with government and faculty practice contracted managed care carriers.


• Initiates correspondence to providers, clinical department personnel, managed care/government carriers and others to obtain required credentialing information for government/managed care enrollment.


• Assists the System FPP business office in resolving provider related denials and rejections, and ensures proper payment for services.


• Communicates billing provider numbers and effective dates to the FPP Information Systems to ensure the billing system is updated.


• Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.

Job Qualification

• Associate's Degree required, or equivalent combination of education and related experience.


• 3-5 years of relevant experience, required.

*Additional Salary Detail


The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).