Talent.com
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
job_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.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.

\n

\n

\n

Provider Enrollment Specialist

\n

\n

\n

\n

\n

\n

Hours : \n

\n

\n

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

\n

\n

\n

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

\n

\n

\n

\n

\n

\n

Job Description : \n

\n

\n

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.

\n

\n

\n

\n

\n

\n

Job Duties and Responsibilities :

\n

\n

\n \n

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

\n \n

\n

\n \n

  • Enter and maintain all provider information into database.
  • \n \n

    \n

    \n \n

  • Verify prospective and current providers’ license, NPI, and other required enrollment documentation.
  • \n \n

    \n

    \n \n

  • Verify accurate banking and billing information.
  • \n \n

    \n

    \n \n

  • Perform ongoing research to correct data so that it does not create duplicate providers, locations, and participation statuses.
  • \n \n

    \n

    \n \n

  • Maintain provider information by reviewing, entering, and following up on missing information.
  • \n \n

    \n

    \n \n

  • Track contract applications status.
  • \n \n

    \n

    \n \n

  • Ensure all files have a welcome, denial, or term letter as appropriate.
  • \n \n

    \n

    \n \n

  • Meet required turnaround times and accuracy rates.
  • \n \n

    \n

    \n \n

  • Keep up-to-date provider enrollment process and records, and track provider participation levels.
  • \n \n

    \n

    \n \n

  • Outreach providers because of mail being returned undelivered to XYZ COMPANY.
  • \n \n

    \n

    \n \n

  • Update the system and the credentialing database to reflect approvals, denials, and / or terminations.
  • \n \n

    \n

    \n \n

  • Facilitate provider-related research based on suspended claims, Call Center escalations and other feedback opportunities.
  • \n \n

    \n

    \n \n

  • Assists call center agents, all internal departments, providers, and potential providers with resolving Provider Enrollment issues and inquiries
  • \n \n

    \n

    \n \n

  • Meets quality controls and production standards of the Provider Relations Department
  • \n \n

    \n

    \n

    \n

    \n \n

  • Assist with other duties as assigned.
  • \n \n

    \n

    \n \n

  • Required Skills :
  • \n \n

    \n

    \n \n

  • Previous experience working with files or the collection and coordination of data (preferred).
  • \n \n

    \n

    \n \n

  • Proficient in the use of Excel.
  • \n \n

    \n

    \n \n

  • Experience with general computer software (Word, Outlook required).
  • \n \n

    \n

    \n \n

  • Ability to learn new software programs quickly.
  • \n \n

    \n

    \n \n

  • Good basic math skills.
  • \n \n

    \n

    \n \n

  • Excellent customer service skills.
  • \n \n

    \n

    \n \n

  • Excellent verbal and written communication skills.
  • \n \n

    \n

    \n \n

  • Professional and effective interaction skills with co-workers, clients, and providers.
  • \n \n

    \n

    \n \n

  • Proven ability to work well individually and as a team member.
  • \n \n

    \n

    \n \n

  • Ability to prioritize and organize multiple tasks.
  • \n \n

    \n

    \n \n

  • Ability to remain organized with multiple interruptions.
  • \n \n

    \n

    \n \n

  • Ability to make independent decisions.
  • \n \n

    \n

    \n \n

  • Strong attention to detail.
  • \n \n

    \n

    \n \n

  • Strong business acumen.
  • \n \n

    \n

    \n \n

  • Ability to adapt to a constantly changing environment.
  • \n \n

    \n

    \n

    \n

    \n

    \n

    Required Experience :

    \n

    \n

    \n

    \n

    \n \n

  • High school diploma or equivalent; Associate’s degree preferred.
  • \n \n

    \n

    \n \n

  • 1–2 years of experience in business environment.
  • \n \n

    \n

    \n

    Preferred Experience

    \n \n

  • Experience working with Medicaid
  • \n

  • Experience with credentialing providers
  • \n \n

    \n

    \n

    \n

    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

    \n

    \n

    \n

    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.

    \n

    \n

    \n

    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.

    \n

    \n

    \n

    \n

    \n

    \n

    \n

    \n

    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.

    \n

    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.

    serp_jobs.job_alerts.create_a_job

    Enrollment Specialist • Concord, NH, US

    Job_description.internal_linking.related_jobs
    100% Work from Home Insurance Enrollment Specialist

    100% Work from Home Insurance Enrollment Specialist

    Global Elite • Manchester, NH, US
    serp_jobs.filters.remote
    serp_jobs.job_card.full_time
    Work From Home Insurance Enrollment Specialist.Due to the rapid expansion of our company, we are looking to hire new associates to our customer service team. Our company works with 45,000 union work...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Advanced Heart Failure – Grafton, WI

    Advanced Heart Failure – Grafton, WI

    Advocate Health • Grafton, US
    serp_jobs.job_card.full_time
    Join Aurora Health Care as an Advanced Heart Failure and Transplant Cardiologist in Grafton, Wisconsin—part of Advocate Health, one of the largest nonprofit integrated health systems in the c...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Recruiter Specialty

    Recruiter Specialty

    Adecco. • Nelson, NH, US
    serp_jobs.job_card.full_time +2
    Executes the steps of the placement cycle for customers and orders with a focus on finance, banking, and creative specialty markets while complying with company policy, employment law, and code of ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
    Accounts Receivable Specialist

    Accounts Receivable Specialist

    CS Contract Solutions • Bedford, NH, US
    serp_jobs.job_card.full_time
    This is a salaried position $35,000 - $41,000 DOE.Job Title : Accounts Receivable Specialist.We offer health, vision, and dental insurance, PTO, and 401k. The Accounts Receivables Specialist position...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    RN / LPN

    RN / LPN

    New Hampshire Catholic Charities • Laconia, NH, US
    serp_jobs.job_card.full_time +1
    Full and Part-Time Opportunities Available!.Weekday Differentials : +$2 / hr for 2nd shift and $5 / hr for 3rd shift.Weekend Differentials : $2 / hr for first shift, $3 / hr for 2nd shift and $6.Outstanding ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Quick offer LPN / LVN

    Quick offer LPN / LVN

    Lancesoft INC • New London, NH, US
    serp_jobs.job_card.full_time
    Shift - Days 8a-5p,week days Mon - fri.Must have a minimum of 3 years of experience and 1 travel contract as a LPN.PHONE Triage and clinical office experience - Required. Certs - LPN license, BLS - ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Product Complaints Specialist

    Product Complaints Specialist

    DEKA Research and Development • Manchester, NH, United States
    serp_jobs.job_card.full_time
    DEKA R&D has an immediate opening for a Product Complaints Specialist to work in a dynamic Medical Device Research and Development environment. The position reports to the Product Complaints Manager...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Billing Reimbursement Specialist

    Billing Reimbursement Specialist

    Blue Lotus Wellness, LLC • Manchester, NH, US
    serp_jobs.job_card.full_time
    Are you detail-oriented, organized, and passionate about supporting mental and physical health care? Blue Lotus Wellness is a growing integrative mental health group practice in Manchester, NH, see...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Home Health Physical Therapist - $65+ per visit

    Home Health Physical Therapist - $65+ per visit

    BAYADA Home Health Care • Georges Mills, NH, United States
    serp_jobs.job_card.full_time
    BAYADA Home Health Care is seeking a Home Health Physical Therapist for a job in Georges Mills, New Hampshire.Job Description & Requirements. Concord NH and surrounding areas.This office services ad...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Southern NH Health System- Physical Therapist- Outpatient Physical Therapy- Full Time

    Southern NH Health System- Physical Therapist- Outpatient Physical Therapy- Full Time

    SolutionHealth • Milford, NH, United States
    serp_jobs.job_card.full_time +1
    UP TO $15,000 SIGN ON BONUS FOR FULL TIME PT POSITIONS Who We Are : In our Physical Therapy department, we are committed to transforming lives through personalized care, cutting-edge techniques, ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Federal Bid Specialist

    Federal Bid Specialist

    Prototek • Concord, NH, United States
    serp_jobs.job_card.full_time
    The Federal Bid Specialist is responsible for supporting our Business Development team specifically related to Defense applications tied to Navsea. This candidate will additionally be responsible fo...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Reserve Occupational Therapist

    Reserve Occupational Therapist

    United States Army • Laconia, NH, US
    serp_jobs.job_card.permanent
    Army Occupational Therapists have the strength to heal our Nation's defenders If you are a professional in the field of occupational therapy and want to combine your specialized skills with a desir...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
    Online Feedback & Opinion Specialist – Flexible Part-Time Role

    Online Feedback & Opinion Specialist – Flexible Part-Time Role

    Opinion Bureau • Concord, NH, US
    serp_jobs.job_card.full_time +1
    Take quick online surveys and earn rewards for sharing your thoughts.Join today — it’s free and easy!.serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
    Family Medicine Physician- New Hampton, Iowa- $150k Bonus & 4 day work-week

    Family Medicine Physician- New Hampton, Iowa- $150k Bonus & 4 day work-week

    Trinity Health • New Hampton, US
    serp_jobs.job_card.full_time
    MercyOne New Hampton Family Medicine.Busy practice with instant volume.Join the team of 3 physicians and 3 APPs.Family practice seeing patients from newborn through elderly.Schedule : 4 ten-hour day...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Reserve Entomologist

    Reserve Entomologist

    United States Army • Laconia, NH, US
    serp_jobs.job_card.full_time
    THE ARMY HEALTH CARE ADVANTAGE As a member of the Army health care team, you'll receive benefits that you won't be able to get in a civilian career. Challenging Work Feel inspired with great case di...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
    Citizens Teller

    Citizens Teller

    Citizens • Meredith, NH, United States
    serp_jobs.job_card.full_time
    Description Starting Salary : $19 / hour and up As a Citizens Teller - YOU make a real difference for our customers and the branch team. What you'll do You’ll greet our customers in our lobbies...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Recruiter / Enrollment Specialist

    Recruiter / Enrollment Specialist

    Community College System of New Hampshire • Manchester, NH, US
    serp_jobs.job_card.full_time
    This role assists the Admissions Office in recruiting and enrolling students by participating in outreach activities and providing support throughout the admissions and enrollment processes.The pos...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Group Facilitator

    Group Facilitator

    Avenues Recovery • Peterborough, NH, US
    serp_jobs.job_card.full_time
    Avenues Recovery Center is a nationwide network of drug and alcohol rehab centers with 17 locations.With an unrivaled, evidence - based clinical curriculum and highly individualized care,.Avenues c...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new