Provider Enrollment Specialist

Summary

Join Hazel Health, a leading virtual provider of school-based healthcare, as a Provider Enrollment Specialist. This remote role focuses on preparing and submitting credentialing applications for behavioral health therapists and clinicians across multiple payers in 14+ states. You will manage enrollment statuses, coordinate data processing, work with clinicians to obtain necessary documentation, and ensure HIPAA compliance. The ideal candidate possesses 3-5 years of credentialing experience with commercial, Medicaid, and Managed Care providers, proficiency in various software, and strong time management skills. Hazel offers competitive compensation, including a base salary range, 401k match, healthcare coverage, paid time off, and other benefits. Apply if you are excited about this role, even if your experience doesn't perfectly align with every qualification.

Requirements

• Two (2) years plus experience utilizing credentialing software such as Availity, Modio and/or Verity
• Three (3) to five (5) years credentialing experience working with commercial, Medicaid and Managed Care providers
• Must be proficient in Google Suite (gdocs,gsheets,gmail) and Internet/Web
• Experience with Salesforce Health Cloud
• Experience navigating state Medicaid, Managed Medicaid, and commercial insurance portals
• Ability to understand how job performance affects the outcomes of key performance indicators such as time to revenue and billing rates
• Self-motivated with excellent decision making and time management skills

Responsibilities

• Manage the timely and accurate submission of provider enrollment applications for all insurance types, including enrollment and reassignment of Medicaid, Managed Medicaid, and commercial programs
• Track and update enrollment statuses on a real-time basis in Salesforce HealthCloud
• Maintain the timelines for all enrollment/credentialing schedules and provide updates to providers and others as needed
• Review Provider Profile information to determine enrollment issues and report on actions taken to resolve those issues
• Coordinate the receipt and processing of all credentialing data needed for enrollment, contracting, and other related purposes
• Work closely with clinicians to obtain missing documentation for providers pertaining to provider enrollment. Obtain required clinician signatures and follow up with the carriers on documentation submitted
• Respond to internal and external inquiries on enrollment and contract matters
• Ensure compliance with all Health Insurance Portability and Accountability Act (HIPAA) standards
• Perform other duties as required or assigned within the scope of responsibility, including supporting other functions and teams within Revenue Cycle

Preferred Qualifications

• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) certification by the National Association of Medical Staff Services
• Associate Degree

Benefits

• Total compensation for this role is market competitive, with a base salary range of $26.75 - $31.50/hr
• 401k match
• Healthcare coverage
• Paid time off
• A broad range of other benefits and perks