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Enrollment Specialist

Company: Preferred Family Healthcare
Location: Saint Charles
Posted on: January 8, 2022

Job Description:

We're a Good Family to Know: Preferred Family Healthcare (PFH) is a community-based healthcare organization that offers a full array of integrated services, serving more than 100,000 individuals each year in nearly 100 locations throughout Missouri, Oklahoma, Kansas and Illinois. Our greatest reward has been the opportunity to serve families and communities in need for the past 40 years. At PFH, our future is brighter than ever! With changes in leadership, focused priorities and strong core values, PFH remains a Good Family to Know! Your role at PFH: As an Enrollment Specialist, you are responsible for performing secretarial, clerical, and administrative support in order to ensure efficient and effective operation. You will:

  • Coordinate all activities related to provider enrollment with various commercial and MCO plans.
  • Complete provider enrollment applications to eligible insurance plans utilizing credentialing software to complete credentialing packets for associates for managed care contracting, and track status per contract in a timely manner. Monitor all submitted applications, enrollment status and complete follow ups as needed.
  • Prepare the CAQH for newly affiliated and existing providers.
  • Research and resolve provider related enrollment issues and coordinate with members of various departments when applicable.
  • Maintain the provider files for revalidation of Medicare via PECOS.
  • Re-attest CAQH information for providers as needed.
  • Responsible for requesting individual provider numbers from Medicare, Medicaid, and other reimbursement entities either through written requests or electronic submission via the Internet.
  • Update and maintain credentialing software including but not limited to adding new hires, new facilities as needed. Maintains all provider insurance enrollments, license, certifications, malpractice insurance and expirables. We think you'd be great for this role if you have:
    • Bachelor's Degree, preference for Healthcare Management, Business Admin, or Medical Billing OR four years of experience in a healthcare, nonprofit, or insurance setting. You'll love being a part of our family because: Our associates are our most valuable asset! We understand the role their satisfaction plays in the quality of services they provide. Through encouragement, our associates are empowered to optimize their strengths through ongoing training to ensure they are equipped and feel competent to serve our clients. Our eligible associates enjoy some of the following PFH Perks:
      • Comprehensive medical, dental, vision, life insurance and disability plan options
      • Competitive 401(k) Retirement Savings Plan up to 5% match!
      • Company paid basic life insurance
      • Paid Time Off Program for vacation, holiday and sick time
      • Emergency Medical Leave Program
      • Flexible Spending Accounts healthcare and dependent child-care
      • Health & Wellness Program
      • Employee Assistance Program (EAP)
      • Employee Discount Program
      • Mileage Reimbursement
      • License/Certification Reimbursement Our human resources team wants to let you know what's required: Employment is conditional upon the receipt of appropriate background checks. Upon offer of employment, you must grant permission for Preferred Family Healthcare to verify accuracy, legitimacy, and results in regards to the following conditions of employment:
        • Background check that includes criminal history and abuse/ neglect.
        • Motor vehicle driving record check.
        • Education and license/certification verification (if applicable).
        • Employment and/or personal reference checks.

Keywords: Preferred Family Healthcare, Saint Charles , Enrollment Specialist, Other , Saint Charles, Missouri

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