Provider Enrollment Specialist

Position: Provider Enrollment Specialist

Company: Heart of the Rockies Regional Medical Center

Location: Salida, CO, USA

Contract Details: Full-time

Heart of the Rockies Regional Medical Center is seeking a highly organized and detail-oriented Provider Enrollment Specialist to join our team in Salida, CO. As a leading healthcare provider in the region, we are committed to providing exceptional care to our patients and community. The Provider Enrollment Specialist will play a crucial role in ensuring that our healthcare providers are properly enrolled and credentialed with insurance companies and government programs.

Key Responsibilities:

• Accurately completes initial/revalidation enrollments and reassignments with all government and commercial insurance payers.
• Coordinates with HRRMC Medical Staff office, providers, and outside organizations to obtain information needed for payer enrollments.
• Ensures current information is on file for all employed providers and all pertinent documentation is forwarded to appropriate third party payers.
• Maintains common data file shared by HRRMC Administration and Medical Staff office.
• Completes and coordinates correspondence to third party payers to expedite provider number assignments and/or revalidation/termination.
• Tracks expiring licenses, certificate of insurance (COI), etc. and proactively updates with payers.
• Maintains provider CAQH, PECOS, NPPES, and Medicaid Profiles.
• Audits Health Plan Directories and ensures accuracy.
• Manages the Provider Enrollment email and responds timely/accurately.1
• Proactively obtains updated information and provides rosters as needed to payers.
• Maintains strict confidentiality of all information.1
• Investigates and resolves any provider enrollment issues that may arise with payers and billing/authorization.
  

Qualifications:

• Minimum of 2 years previous experience in Provider Enrollment, Payment Posting, Billing, and/or Collections; or equivalent combination of education and experience. 

• Preferred 1 year direct experience in Provider Enrollment.
  

We offer a competitive salary and benefits package, including medical, dental, and vision insurance, retirement plans, and paid time off. If you are a motivated and detail-oriented individual with a passion for healthcare, we encourage you to apply for this exciting opportunity to join our team at Heart of the Rockies Regional Medical Center.