The Provider Enrollment Specialist is responsible for coordinating all necessary provider enrollment applications for billing to various carriers.  This position is also responsible for ensuring all applicable documents have been sent/received in a timely manner to the authorized signer and preparing/submitting a completed payer application.  Responsibilities also include completing all CAQH re-attestations, online application and re-enrollment applications.

• Responsible for the successful implementation of the entire enrollment and credentialing process for clients who request provider enrollment services. 
• Coordinates credentialing date needed for enrollment, contracting and other related purposes.  Credentialing data includes but is not limited to the Drug Enforcement Administration (DEA) number, state license number, Board certificates, CV, malpractice insurance and state insurance form.  Documents date in internal systems.
• Must maintain timelines on enrollment/credentialing schedules.
• Communicates with providers and other departments to coordinate updates as needed, clarify carrier information requirements, and maintain a strict level of confidentiality for all matters pertaining to provider credentials.
• Works closely with the facility’s designated representatives to obtain missing documentation for providers pertaining to provider enrollment.  Obtains required client signatures and follows up with the carriers on documentation submitted.
• Reviews new client packet information received to determine the enrollment issues that need to be addressed.
• Maintains provider information via spreadsheets and provider enrollment software, including demographics for all providers.
• Generates internal reports.
• Reviews weekly exception reports from management to prioritize critical issues.
• Updates management when payers request additional forms or updating PE forms.
• Responds to internal and external inquiries on routine enrollment and contract matters, as appropriate.
• Prepares and sends applications to payers.
• Completes online applications/CAQH.
• Resolves application deficiencies.
• Trains staff on provider enrollment.
• Emergency duty may be required of the incumbent that includes working in Red Cross shelters or to perform other emergency duties including, but not limited to, responses to threats or disasters, man-made or natural.

Education:

• High School Diploma/GED required. Associate's degree or higher preferred.

Experience:

• Minimum one (1) year of provider enrollment or medical billing experience required. Must be detail oriented and thorough in order to ensure the complex enrollment packages are complete and correct.
• Ability to communicate well with a wide variety of contacts and at all levels of the organization required.
• Must be able to work cohesively in a team oriented environment and be able to foster good working relationships with others both within and outside the organization.

Licensure:

• Valid Florida Driver's License required.

Training:

• Knowledge of Microsoft applications required.

Health Care District of Palm Beach County is proud to be an Equal Opportunity Employer and Drug Free Workplace. We embrace diversity and do not discriminate based onrace, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.