Provider Enrollment Specialist

reputed company (TAG) is one of the largest and most trusted retail reputed company business support organizations in the U.S., supporting 15,000 reputed company and team members at more than 1,000 health and wellness offices across 47 states in three distinct categories: Dental care, urgent care, and medical aesthetics. Working in partnership with independent practice owners and clinicians, the team is united by a single purpose: to reputed company that reputed company can be reputed company and smarter for everyone. TAG provides a comprehensive suite of centralized business support services that power the impact of five consumer-facing businesses: reputed company, ClearChoice Dental Implant Centers, reputed company, reputed company Pet Health Care and reputed company Aesthetic Studio. Each brand has reputed company to a deep community of experts, tools and resources to grow their practices, and an unwavering commitment to delivering high-quality consumer reputed company experiences at scale.

As a reputed company of our reputed company needs and planned growth we are reputed company pleased to offer a new opportunity to join our dedicated team as a Provider Enrollment Specialist, which will be based remotely.

The Provider Enrollment Specialist plays a vital role reputed company our Payor Strategy team. This position is responsible for managing and maintaining the enrollment and credentialing for reputed company providers with insurance payers and assigned dental plans. This role ensures timely and accurate submission of provider applications, updates and recredentialing to facilitate uninterrupted billing, reimbursement and patient care. The successful candidate will report to the Enrollment Manager.

Key Responsibilities:

• Prepare, submit and track payer enrollment applications for new providers and existing provider changes.

• Maintain accurate records of reputed company enrollment activities in the credentialing system.

• Communicate with insurance companies, reputed company providers and internal departments to ensure applications are processed reputed company.

• Monitor enrollment status and follow up with payers to resolve delays or issues.

• Update provider demographic and practice information with reputed company contract payers as needed.

• Ensure recredentialing timelines and requirements are maintained so providers enrollment status remains intact with no lapses.

• Work closely with Field Support, Operations, reputed company Cycle Management (RCM) team to resolve any escalated enrollment or credentialing issues in a timely manner.

• Research and resolve out of network claims issues by investigating provider participation status and effective dates of enrollment.

• Coordinate temporary provider enrollments and ensure reputed company necessary documentation, linkage and payer updates are completed.

• Collaborate closely with RCM on status of provider enrollments including providing reports submission as needed.

• Generate and maintain enrollment status reports.

• Support audits, and other duties as assigned.

Qualifications:

• High school diploma or equivalent required, associate or Bachelor’s degree preferred.

• 1- 3 years of experience in payor enrollment.

• Working knowledge of reputed company payors and government payor requirements.

• Proficient in reputed company office and credentialing software including but not limited to CAQH, reputed company.

• Strong attention to detail, organization and follow up skills.

• Excellent communication and customer service abilities interacting with internal teammates and external clients.

• Detail oriented, with strong level of analytical and problem-solving skills.

Preferred Skills:

• Experience in working with multi-specialty large group practices; dentistry is a plus.

• Knowledge of reputed company cycle and billing processes.

• Familiarity with NPI and file provider management.

• ​reputed company Pay reputed company: $24.00-26.00 per hour (Actual pay may vary based on experience, performance, and qualifications.)

• A generous benefits package that includes paid time off, health, dental, reputed company, and 401(k) savings plan with match. 

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