Credentialing & Enrollment Specialist
Company Description
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers
Job Description
The Enrollment Specialist will be the primary contact for the Enrollment Department for all Privia
independent providers and responsible for all aspects of managing the payer enrollment process for this
market.
The Enrollment Specialist will take steps necessary to enroll all new groups and providers with the
contracted payers in the designated 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 athenaNet 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 or other credentialing experience 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 proje
management
Must comply with HIPAA rules and regulations
Interpersonal Skills & Attributes:
An individual with the ability to communicate appropriately and effectively with provider
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 a
effective solutions
The salary range for this role is $45,000.00 - $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.
Additional Information
All your information will be kept confidential according to EEO guidelines.
Technical Requirements (for remote workers only, not applicable for onsite/in office work):
In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.
Apply Now
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers
Job Description
The Enrollment Specialist will be the primary contact for the Enrollment Department for all Privia
independent providers and responsible for all aspects of managing the payer enrollment process for this
market.
The Enrollment Specialist will take steps necessary to enroll all new groups and providers with the
contracted payers in the designated 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 athenaNet 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 or other credentialing experience 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 proje
management
Must comply with HIPAA rules and regulations
Interpersonal Skills & Attributes:
An individual with the ability to communicate appropriately and effectively with provider
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 a
effective solutions
The salary range for this role is $45,000.00 - $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.
Additional Information
All your information will be kept confidential according to EEO guidelines.
Technical Requirements (for remote workers only, not applicable for onsite/in office work):
In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.
Apply Now