Credentialing Enrollment Specialist
The Enrollment Specialist will be the primary contact for the Enrollment Department for all Privia
independent providers and responsible for all aspects of managing the payer enrollment process for this
market.The Enrollment Specialist will take steps necessary to enroll all new groups and providers with the
contracted payers in the designated market including all commercial and federal payers.
The Enrollment Specialist will manage all payer data in CredentialStream for both the group and
the individual providers.
The Enrollment Specialist will take steps necessary to investigate all claims/enrollment related
issues or questions with the care centers.
Work within athenaNet EMR to resolve inbound claims related inquiries.
Partners with internal and external partners in the onboarding process including the National
Credentialing Team Implementation Team and Operations Consultants.
Resolution of Salesforce cases and management of issues and the team resolving the cases is a
key element in this role.
Act as liaison between Enrollment Department and both internal and external stakeholders
Other duties as assignedQualifications :
2 years experience in payer enrollment function
Verity or other credentialing experience preferred
Medicare/Medicaid payer experience required
Athena EMR experience preferred
Demonstrated skills in problem solving and analysis and resolution
Advanced Microsoft Excel skills
Must be able to function independently possess demonstrated flexibility in multiple proje
management
Must comply with HIPAA rules and regulations
Interpersonal Skills & Attributes:
An individual with the ability to communicate appropriately and effectively with provider
including sensitive and confidential information
An individual who is passionate about playing a key role in changing the current healthcare
environment
High level of attention to detail with exceptional organizational skills
Exercise independent judgment
Ability to problem solve and explore all options and to use available resources to find new a
effective solutions
The salary range for this role is $45000.00$55000.00 in base pay and exclusive of any bonuses or benefits (medical dental vision life and pet insurance 401K paid time off and other wellness programs). This role is also eligible for an annual bonus targeted at 10%.The base pay offered will be determined based on relevant factors such as experience education and geographic location.Additional Information :
All your information will be kept confidential according to EEO guidelines.
Technical Requirements (for remote workers only not applicable for onsite/in office work):
In order to successfully work remotely supporting our patients and providers we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests likeThis gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age color national origin physical or mental (dis)ability race religion gender sex gender identity and/or expression marital status veteran status or any other characteristic protected by federal state or local law.Remote Work :
YesEmployment Type :
Fulltime
Apply Now
independent providers and responsible for all aspects of managing the payer enrollment process for this
market.The Enrollment Specialist will take steps necessary to enroll all new groups and providers with the
contracted payers in the designated market including all commercial and federal payers.
The Enrollment Specialist will manage all payer data in CredentialStream for both the group and
the individual providers.
The Enrollment Specialist will take steps necessary to investigate all claims/enrollment related
issues or questions with the care centers.
Work within athenaNet EMR to resolve inbound claims related inquiries.
Partners with internal and external partners in the onboarding process including the National
Credentialing Team Implementation Team and Operations Consultants.
Resolution of Salesforce cases and management of issues and the team resolving the cases is a
key element in this role.
Act as liaison between Enrollment Department and both internal and external stakeholders
Other duties as assignedQualifications :
2 years experience in payer enrollment function
Verity or other credentialing experience preferred
Medicare/Medicaid payer experience required
Athena EMR experience preferred
Demonstrated skills in problem solving and analysis and resolution
Advanced Microsoft Excel skills
Must be able to function independently possess demonstrated flexibility in multiple proje
management
Must comply with HIPAA rules and regulations
Interpersonal Skills & Attributes:
An individual with the ability to communicate appropriately and effectively with provider
including sensitive and confidential information
An individual who is passionate about playing a key role in changing the current healthcare
environment
High level of attention to detail with exceptional organizational skills
Exercise independent judgment
Ability to problem solve and explore all options and to use available resources to find new a
effective solutions
The salary range for this role is $45000.00$55000.00 in base pay and exclusive of any bonuses or benefits (medical dental vision life and pet insurance 401K paid time off and other wellness programs). This role is also eligible for an annual bonus targeted at 10%.The base pay offered will be determined based on relevant factors such as experience education and geographic location.Additional Information :
All your information will be kept confidential according to EEO guidelines.
Technical Requirements (for remote workers only not applicable for onsite/in office work):
In order to successfully work remotely supporting our patients and providers we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests likeThis gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age color national origin physical or mental (dis)ability race religion gender sex gender identity and/or expression marital status veteran status or any other characteristic protected by federal state or local law.Remote Work :
YesEmployment Type :
Fulltime
Apply Now