Provider Enrollment Specialist – Remote – Nationwide

Remote, Nationwide – Seeking Provider Enrollment Specialist

Everybody Has A Role To Play In Transforming Healthcare

If you want to be part of changing healthcare to better serve patients, you are in the right place. With Vituity you will join a team of individuals dedicated to our culture of caring and work to develop and implement innovative solutions, while tackling some of the healthcare industry’s most challenging situations from the inside.

Join the Vituity Team. At Vituity, our core values matter. We embody a Culture of Caring by approaching every human interaction with compassion and heart. With a Servant Leadership philosophy, we focus on what we can accomplish when we put our patients and colleagues first. An Ownership Mentality means we all have mutual accountability to drive positive change for Vituity as a whole. Finally, our focus on Innovation enables all of us to re-imagine healthcare and bring about lasting change. Ultimately, we are unified around the common purpose of transforming healthcare to improve lives, and we believe everyone has a role to play in that. Help us shape the future of healthcare.

Vituity Locations: Vituity has opportunities at 450 practice locations across the country, serving 8 million patients a year. With Vituity, if you ever need to move, you can take your job with you.

The Opportunity

  • Prepare, submit, and scan provider enrollment applications for Medicare, Medicaid, Blue Cross, Blue Shield, CAQH and other payer programs as needed.
  • Submit selected applications to supervisor/manager for audit, working towards not needing any applications to be audited.
  • Follow up with payers on applications as frequently as every 2 weeks.
  • Monitor submitted provider enrollment applications to ensure approvals are received timely, based on established best practices of Medicare in less than 3 months, Medi-Cal in less than 6 months, other Medicaids in less than 4 months, BC and BS in less than 3 months, working towards the team’s overall goal of not having pending applications over 6 months after the start date.
  • Update records in Salesforce with billing numbers, contract information, submission dates of applications, and notation of any communications or problems that require attention. Records extensive documentation in databases for any ongoing or open tasks.
  • Deactivate inactive providers from Medicare, Medicaid, and other payers as needed.
  • Pull documents (credentials, etc.) as needed for payer requests, Payer Management team, billing company, etc.
  • Serve as liaison between billing company, providers, and payer representatives to resolve all provider enrollment issues with assistance from supervisor/manager.
  • Advise billing company of approvals when obtained.
  • Research many payer issues and work to resolve with payers and billing company quickly and effectively so issues do not return, with oversight from supervisor/manager.
  • Update and maintain the workflow for your states/practice lines.
  • Participate in projects for assigned states/practice lines as needed.
  • Support other team projects or duties as assigned.
  • Suggest, initiate, and implement process improvement ideas for whole PE team.
  • Participate in payer trainings and webinars as needed.

Required Experience and Competencies

  • Prior work experience in an office or healthcare environment required.
  • Bachelor’s degree in related field of study preferred.
  • Knowledge of billing or reimbursement preferred.
  • Provider Enrollment experience preferred.
  • Ability to effectively interact with providers, payer representatives, internal departments, team members, and other stakeholders, both in written and verbal communication.
  • Ability to accomplish tasks thoroughly and accurately.
  • Ability to effectively manage time and organize.
  • Ability to learn billing processes, including timely filing and claims denial reasons.
  • Proficient in Microsoft Office Suite (Word, Excel, Outlook, OneNote, OneDrive, PowerPoint, etc.).
  • Knowledge of additional technology-based assistance (Teams, Box, SharePoint, etc.).
  • Knowledge of online Medicare/Medicaid enrollment systems, Identity & Access system, Counsel for Affordable Quality Healthcare system, Medicare enrollment specialties, and National Provider Identifier taxonomies.
  • Knowledge of Medicaid enrollment process (including revalidations, medical license expirations, deactivations, NPI taxonomy importance, how data flows to Medicaid managed cares, Medicaid billing manuals, state administrative codes, border state enrollment process, out of state enrollment process, etc.).
  • Knowledge of Salesforce (including Individual Enrollment Contracts, Group Enrollment Contracts, Contracts, Work History, Provider Status, and Clinical Activities objects), and utilizing dashboards and reporting to develop internal preference for ongoing workload management.
  • Develop critical thinking skills and professional relationships.

The Community

Even when you are working remotely, you are an important part of the Vituity Community. We offer plenty of opportunities to engage with other Vitans through a variety of virtual meet-and-greets, events and seminars.

  • Monthly wellness events and programs such as yoga, HIIT classes, and more.
  • Trainings to help support and advance your professional growth.
  • Team building activities such as virtual scavenger hunts and holiday celebrations.
  • Flexible work hours.
  • Opportunities to attend Diversity, Equity and Inclusion (DEI) events including LGBTQ+ History, Día de los Muertos Celebration, Money Management/Money Relationship, and more.

Benefits & Beyond*

Vituity cares about the whole you. With our comprehensive benefits package, we are mindful of what matters most, and support your needs of today and your plans for the future.

  • Superior health plan options
  • Dental, Vision, HSA/FSA, Life and AD&D coverage, and more
  • Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6%
  • Outstanding Paid Time Off: Four weeks’ vacation, Paid holidays, Sabbatical
  • Student Loan Repayment Program
  • Professional and Career Development Program
  • EAP, travel assistance and identify theft included 
  • Wellness program
  • Commuter Benefits Program
  • Diversity, Equity and Inclusion (DEI) initiatives including LGBTQ+ History, Día de los Muertos Celebration, Money Management/Money Relationship, and more.
  • Purpose-driven culture focused on improving the lives of our patients, communities, and employees.

Salary range is $22.90 – $28.63 per hour. Please speak with a recruiter for more information.

We are unified around the common purpose of transforming healthcare to improve lives and we believe everyone has a role to play in that. We know that when we work together across sites and specialties as an integrated healthcare team, we can exceed the expectations of our patients and the hospitals and clinics we work in. If you are looking to make a difference, from clinical to corporate, Vituity is the place to do it. Come grow with us.