The PES Account Specialist is responsible for provider enrollment into Federal, State, and commercial health plans, correspondence with provider's office, gathering of provider data needed for enrollment, completion of provider applications and follow-up with health plans until provider is fully enrolled. Also, responsible for advising the provider's office concerning best practices and procedures pertaining to enrollment. This is a remote opportunity.
Duties & Responsibilities
Communicate & advise the provider or designated contact person of the paperwork necessary to begin the enrollment process for new providers, explaining timeline expectations
Research payer requirements to gather all details to appropriately enroll provider
Maintain contact with designated contact person to obtain application signatures and collect all required documents to include with the completed applications
Key all provider demographics & enrollment data into software system
Scan all related enrollment documents and applications into software system
Contact health plans to request provider enrollment application packages and/or required action for enrollment and continue follow-up with insurance plans by telephone or email until all provider numbers are issued
Prepare & distribute Payor Affiliation Reports and Status Notes to designated contact person(s) for each provider every 2-3 weeks in order to communicate the progress of approved provider numbers
Ability to interact positively in a team environment, demonstrating superior teamwork skills
Interacts professionally with Symplr staff and occasional interaction with outside organizations
Verbal and communication skills are required to resolve issues
Other duties as assigned
Skills Required
Ability to interact positively in a team environment, demonstrating superior teamwork and leadership skills
Superior attention to detail and organizational skills
Excellent time management skills, resource organization and priority establishment skills, and ability to multi-task in a fast-paced environment
Ability to effectively interface and communicate, both written and verbal, with all levels inside and outside the company
Ability to manage assigned projects individually, without supervision, and make independent decisions
Consistently demonstrates flexibility, a customer-focus, terrific organizational skills and a passion for details
Consistently meets project deadlines and communicates any projected delays with manager/director in advance of deadlines to ensure client needs are met
Proficiency with credentialing systems and learns new systems/processes quickly
Qualifications:
Every organization has a culture, whether they mean to or not, so why not be intentional about it?
Together, if we shape our intentions, actions, and interactions around a common, purposeful culture, we are able to quickly achieve more, attract others who help realize our goals, and thrive in our professional relationships.
Bachelor's degree desired
2+ years in directly applicable experience in Payor/Provider Enrollment or Credentialing required
Experience with Microsoft Office Suite including Word, PowerPoint, and Excel