Job description

Physical Rehabilitation Network is seeking an enthusiastic and versatile Provider Enrollment Specialist to join our dynamic team of professionals. Provider Enrollment is responsible for provider enrollment process, workflows and controls associated with government and commercial payers. We take pride in our ability to provide the highest level of superior customer service.

Schedule:

• Monday-Friday
• 9:5

Benefits:

• Health insurance
• Paid time off
• Dental insurance
• 401(k)
• Vision insurance
• Life insurance
• 401(k) matching
• Retirement plan
• Referral program
• Employee discount
• Flexible spending account
• Health savings account
• Professional development assistance
• Employee assistance program
• Other

Responsibilities:

• Complete required enrollment applications via Health Plan website, Health Plan roster or PDF applications to all commercial/contracted payers daily.
• Audit all applications before submitting to payers ensuring they are completed accurately.
• Follow up on all enrollment submissions to confirm receipt and turnaround time until approved.
• Maintain recredentialing and revalidation statuses for existing providers with commercial payers.
• Review and validate all provider directory verification requests from applicable payers on an ongoing- basis.
• Verify directory information on Health Plan Portals to ensure data is complete and accurate.
• Research all licensing and credentialing requirements within assigned region and stay current on relevant health plan, state and federal regulatory requirements.
• Research and resolve any payer issues with direct relation to provider enrollment.
• Provide weekly productivity reports to management.
• Maintain privacy and confidentiality of all providers, company, and other sensitive information in accordance with HIPAA guidelines.
• Participate in departmental and interdepartmental meetings.
• Assist with any special projects and/or duties, as needed.

Experience/Skills needed:

• Enrollment experience with commercial and government entities.
• Credentialing experience
• Technology competence
• Excel
• Time Management
• Critical thinking skills
• CAQH knowledge along with Credentialing/Payor Enrollment Database management

About Us:

For over 30 years, Physical Rehabilitation Network (PRN) has specialized in delivering quality physical therapy care and workplace ergonomics solutions, complemented by its respected comprehensive practice management solutions, which provide non-clinical administrative support services to physical therapists. We are known for our leading, value-driven practice management services and innovative, outcomes-driven physical therapy care models which support our growing network of 16 states across the western and central portions of the U.S

We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.

#t3

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Application Question(s):

• Salary expectations?

Experience:

• Credentialing: 2 years (Required)

Work Location: In person

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