[Hiring] Enrollment Specialist @Privia Health

Role Description

The Enrollment Specialist will be the primary contact for the New Jersey Market’s Enrollment Department for all Privia independent providers and care centers, and responsible for all aspects of managing the payer enrollment process.

• The Enrollment Specialist will take steps necessary to enroll all new groups and providers with the contracted payers in the Florida 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 AthenaOne 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 assigned.

Qualifications

• 2+ years’ experience in payer enrollment function.
• Verity CredentialStream or other credentialing experience preferred.
• Familiar with working in PECOs preferred.
• Experience working with providers & payers in New Jersey 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 project management.
• Must comply with HIPAA rules and regulations.

Requirements

• An individual with the ability to communicate appropriately and effectively with providers; 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 and effective solutions.

Benefits

• The salary range for this role is $50,000.00-$55,000.00 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.