Provider Enrollment Specialist (Hollywood Corporate)

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    "jobTitle": "Provider Enrollment Specialist (Hollywood Corporate)",
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    "description": "<p style=\"text-align:center;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><strong><u><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#808080;\">Provider Enrollment Specialist</span></span></span></u></strong></span></span></p>\n\n<p style=\"text-align:center;\"> </p>\n\n<p><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Dermcare Management has an excited opportunity for the right candidate in our Hollywood, Florida location. Our Enrollment Coordinator role is a full-time role that will offer major medical, dental vision and other ancillary benefits. The role could be hybrid remote. The role offers earn Paid Time Off that can be taken as soon as 90 days of employment. </span></span></span></span></span></p>\n\n<p><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">The Enrollment Coordinator provides overall support to the Provider Enrollment Manager, as related to Provider enrollment, and other administrative tasks as assigned, while working closely with other departments including the Revenue Cycle team and Physician Credentialing. </span></span></span></span></span></p>\n\n<p><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><strong><u><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Role Responsibilities:</span></span></span></u></strong></span></span></p>\n\n<ul>\n\t<li><span style=\"font-size:11pt;\"><span style=\"color:#000000;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Perform the administrative and enrollment duties necessary to complete the provider enrollment process for Insurance purposes.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"color:#000000;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Work directly with administrative contacts and departments which include: performing regular updates and communicating clearly on the status of the enrollment process to all departments and offices who require frequent updates. </span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"color:#000000;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Provide superior customer service at all times to internal and external contacts including office managers, providers, payer representatives, and other staff members. </span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"color:#000000;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Help with managing the onboarding process by working directly with providers to help facilitate the process of enrollment with insurance payers.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"color:#000000;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Manage the enrollment/credentialing process from start to finish including obtaining applications from the payers, completing applications accurately, submitting applications timely per policy or within a reasonable time frame to avoid delays.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"color:#000000;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Complete regular follow up with the payers to ensure applications are being processed, and obtaining confirmation once the credentialing/enrollment process is completed. </span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"color:#000000;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Updating direct report on all completed applications. </span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"color:#000000;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Act as liaison between practitioners and payers, identifying delays with payers, escalate and communicate delays or issues timely to management.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"color:#000000;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Properly maintain files on each provider as required by the department, items may include (CAQH upkeep. Payor revalidations, verifications, practice updates and others as directed by management). </span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"color:#000000;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Work closely with the other team members to ensure that the enrollment is handled as quickly and professionally as possible.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"color:#000000;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Maintain knowledge of requirements for credentialing providers with contracted health plans. </span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"color:#000000;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Provide consistent upkeep of provider enrollment status throughout the enrollment cycle and documenting each step of the process in the provider database (Modio).</span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"color:#000000;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Audit and update health plan directories for current and accurate agency and provider information, as well as primary contacts.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"color:#000000;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Generate and maintain weekly and monthly reports of credentialing and enrollment processes.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"color:#000000;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Responds to staff, provider, payer and other stakeholder inquiries and requests in a timely manner.</span></span></span></span></span></li>\n</ul>\n\n<p><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><strong><u><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Essential Functions:</span></span></span></u></strong></span></span></p>\n\n<ul>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Physical Demands will include sitting, standing, walking, bending, stooping, squatting, kneeling, pushing/pulling, twisting, climbing stairs.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Lifting to 10 pounds.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Looking at a computer screen for up to 8 hours a day.</span></span></span></span></span></li>\n</ul>\n\n<p><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><strong><u><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Benefits:</span></span></span></u></strong></span></span></p>\n\n<ul>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Medical, Dental and Vision Insurance with FSA/HSA with in first 90 days.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Ability to work a Hybrid Schedule.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">PTO accrued and ability to use after the first 90 days. </span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">401K with matching. </span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Working in a team environment. </span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Onsite training directly with the Provider Manager.</span></span></span></span></span></li>\n</ul>\n\n<p> </p>\n\n<p><span style=\"font-size:11pt;\"><span style=\"background-color:#FFFFFF;\"><span style=\"font-family:Calibri, sans-serif;\"><strong><u><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Skills &amp; Abilities:</span></span></span></u></strong></span></span></span></p>\n\n<ul>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Extremely organized and flexible with the ability to simultaneously handle the enrollment and credentialing functions of the department. </span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Sound work ethics with the ability to make independent decisions, be detail oriented with excellent written and verbal communication skills. </span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Ability to interact with staff in a fast-paced environment, sometimes under pressure, remaining flexible, proactive, resourceful and efficient. Must be able to work in a Team oriented environment.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Ability to exhibit a high level of professionalism and confidentiality. </span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Excellent customer service skills and positive demeanor. </span></span></span></span></span></li>\n</ul>\n\n<p style=\"margin-left:0in;margin-right:0in;\"> </p>",
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    "qualifications": "<p><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><strong><u><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Qualifications &amp; Experience Required:</span></span></span></u></strong><strong>   </strong></span></span></p>\n\n<ul>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Must have a basic knowledge of healthcare credentialing, licensure, certification, and CAQH.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Must have a knowledge of Provider Enrollment with Payors.  An understanding of IPA’s and PHO’s is a plus but not required.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Microsoft Office experience, specifically Excel. </span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Modio experience is a plus. </span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Experience working with health insurance, including CMS and Medical Assistance is a plus.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">2-3 years of experience specifically related to Provider enrollment.</span></span></span></span></span></li>\n</ul>",
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