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Provider Enrollment Specialist
Provider Enrollment SpecialistConduent State Healthcare, LLC • Concord, NH, US
Provider Enrollment Specialist

Provider Enrollment Specialist

Conduent State Healthcare, LLC • Concord, NH, US
1 day ago
Job type
  • Full-time
Job description

Job Description

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.

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Provider Enrollment Specialist

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Hours : \n

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8 : 00 AM- 4 : 30 PM; Monday through Friday

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$17 per hour, which may be below your state's minimum wage.  Please take this into consideration when applying.

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Job Description : \n

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Primary responsibilities include taking a new provider application from receipt to inclusion in directory and making ongoing updates. This involves accurate and timely entry of provider data, including provider applications and contact information, status changes, and revalidations. It also includes verification of all the credentialing criteria for providers that have applied to NH Medicaid through initial application, and following up with providers as needed to obtain information for the enrollment process.

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Job Duties and Responsibilities :

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  • Enter and maintain provider applications, revalidations, and updates into the system.

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  • Enter and maintain all provider information into database.
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  • Verify prospective and current providers’ license, NPI, and other required enrollment documentation.
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  • Verify accurate banking and billing information.
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  • Perform ongoing research to correct data so that it does not create duplicate providers, locations, and participation statuses.
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  • Maintain provider information by reviewing, entering, and following up on missing information.
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  • Track contract applications status.
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  • Ensure all files have a welcome, denial, or term letter as appropriate.
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  • Meet required turnaround times and accuracy rates.
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  • Keep up-to-date provider enrollment process and records, and track provider participation levels.
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  • Outreach providers because of mail being returned undelivered to XYZ COMPANY.
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  • Update the system and the credentialing database to reflect approvals, denials, and / or terminations.
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  • Facilitate provider-related research based on suspended claims, Call Center escalations and other feedback opportunities.
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  • Assists call center agents, all internal departments, providers, and potential providers with resolving Provider Enrollment issues and inquiries
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  • Meets quality controls and production standards of the Provider Relations Department
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  • Assist with other duties as assigned.
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  • Required Skills :
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  • Previous experience working with files or the collection and coordination of data (preferred).
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  • Proficient in the use of Excel.
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  • Experience with general computer software (Word, Outlook required).
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  • Ability to learn new software programs quickly.
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  • Good basic math skills.
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  • Excellent customer service skills.
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  • Excellent verbal and written communication skills.
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  • Professional and effective interaction skills with co-workers, clients, and providers.
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  • Proven ability to work well individually and as a team member.
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  • Ability to prioritize and organize multiple tasks.
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  • Ability to remain organized with multiple interruptions.
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  • Ability to make independent decisions.
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  • Strong attention to detail.
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  • Strong business acumen.
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  • Ability to adapt to a constantly changing environment.
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    Required Experience :

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  • High school diploma or equivalent; Associate’s degree preferred.
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  • 1–2 years of experience in business environment.
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    Preferred Experience

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  • Experience working with Medicaid
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  • Experience with credentialing providers
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    Pay Transparency Laws in some locations require disclosure of compensation and / or benefits-related information.  For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and / or sick time. The estimated hourly rate for this role is $17.00

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    Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex / gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military / veteran status, citizenship status, basis of genetic information, or any other group protected by law.

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    For US applicants : People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded :   click here to access or download the form.  Complete the form and then email it as an attachment to  FTADAAA@conduent.com.  You may also click here to access Conduent's ADAAA Accommodation Policy.

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    Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex / gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military / veteran status, citizenship status, basis of genetic information, or any other group protected by law.

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    For US applicants : People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded :   click here to access or download the form.  Complete the form and then email it as an attachment to  FTADAAA@conduent.com.  You may also click here to access Conduent's ADAAA Accommodation Policy.

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    Enrollment Specialist • Concord, NH, US

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