Job Details

We are seeking a dedicated and detail-oriented Provider Enrollment Specialist to join our team in Austin, TX. In this role, you will handle provider enrollment and file maintenance for Medicaid programs, ensuring all applications and requests are processed accurately and timely. This position requires excellent problem-solving skills, adaptability, and the ability to manage strict deadlines in a growing work environment.

Key Responsibilities:

1. Interact professionally with providers and ancillary staff to address inquiries and concerns regarding Medicaid provider enrollment (e.g., dental, vision, ambulance, physicians, nurses, and other provider types).
2. Process assigned applications and maintenance requests to completion, meeting daily quotas while adhering to documented work instructions.
3. Identify deficiencies in applications, notify providers of inaccuracies, and revise deficiencies based on QA audit feedback.
4. Respond to inquiries about the status of applications and maintenance requests.
5. Conduct research and resolve enrollment application deficiencies by contacting providers via phone.
6. Ensure adherence to the Quality Assurance (QA) program, achieving a minimum quality score of 98%.
7. Make recommendations to management to enhance the efficiency and effectiveness of enrollment processes.
8. Maintain strict confidentiality of all information and job files, complying with HIPAA requirements.
9. Demonstrate flexibility by working overtime as needed to meet production inventory requirements.
10. Perform other duties as assigned by leadership.

Basic Qualifications:

Experience: Minimum of 6 months of experience enrolling and credentialing healthcare providers.

Skills:

• Strong computer skills.
• Ability to meet strict deadlines.
• Attention to detail and organizational abilities.
• Excellent written and verbal communication skills.
• Effective problem-solving and multitasking capabilities.
• Flexibility and adaptability to work in a dynamic environment.