Provider Enrollment Specialist Position Available In Wake, North Carolina

Provider Enrollment Specialist#25-02870
Raleigh, NC
90% Remote
Job Description
: Provider Enrollment Specialist

JOB LOCATION

Remote but must go to office 4 days a month in Raleigh

WAGE RANGE

•:$15-16/hour

JOB NUMBER

25-02870
REQUIRED

EXPERIENCE

Requires 2 years administrative experience
Knowledge of NC Medicaid or Healthcare
Working knowledge of NCTracks
Working knowledge of provider enrollment requirements
Proficient with Microsoft suite

JOB DESCRIPTION

Our client is currently seeking a Provider Enrollment Specialist in Raleigh NC. In this role you will be a change agent by conducting operational audits and verifying that operational procedures are followed correctly for the Provider Enrollment Section. This section is responsible for enrolling providers for the NC Medicaid Programs.

RESPONSIBILITIES

Process provider enrollment applications to ensure new and currently enrolled providers are within compliance within NC State regulations.
Validate the qualifications of licensed professionals, organizational members or organizations
Render a determination that an organization or entity meets the established qualifications, requirements and/or standards to provide a service or procedure as outlined in the State business rules/desk procedures.
Perform and assess the background check through Lexis Nexis, AAR and PPTD.
Perform source verification of licensure, certification, endorsements and accreditation’s through Lexis Nexis or State Licensure Board.
Deny providers that do not meet the requirements.
Meet performance quality standards on a daily basis.
Meet performance quantity standards on a daily basis.

QUALIFICATIONS

Requires Skills and Experience:

Requires 2 years administrative experience
Knowledge of NC Medicaid or Healthcare
Working knowledge of NCTracks
Working knowledge of provider enrollment requirements
Proficient with Microsoft suite
Training Schedule is as follows:
In-person training is 2.5 weeks.
Nesting is 1 month.
Nesting will be onsite from Tuesday – Thursday; Remote work will be on Monday and Friday.
Role will transition to hybrid remote after nesting; consisting of in office at least 4 days a month.

Training Hours:

First day is 8:30 am-5 pm EST and all remaining training days will be 8:00am – 4:30pm Monday – Friday, with a 30-minute lunch.
Essential Job Functions
Answers incoming phone calls on behalf of client; provides accurate and appropriate information to callers.
Places outbound customer service or customer satisfaction calls, as required by client.
Completes call guides; gathers and verifies required information.
Attends telephone skills and program information training sessions; adheres to established levels of service.
Adheres to established customer service and documentation standards within required time frames.
Adheres to contact center scheduling, ensures telephone coverage during contact center hours of operation.
Performs clerical or administrative duties as assigned.

WHAT YOU’LL NEED TO SUCCEED

Required Experience :

1+ years of related experience

Required Skills and Abilities :

customer service, communication, problem solving

Preferred Skills :

customer service

Location :

Hybrid – 2 days a month onsite

Citizenship Required :

US Person (Green Card Holder/US Permanent Resident Alien, Refugee, Asylee, US Citizen)
Equal opportunity employer as to all protected groups, including protected veterans and individuals with disabilities
• While an hourly range is posted for this position, an eventual hourly rate is determined by a comprehensive salary analysis which considers multiple factors including but not limited to: job-related knowledge, skills and qualifications, education and experience as compared to others in the organization doing substantially similar work, if applicable, and market and business considerations. Benefits offered include medical, dental and vision benefits; dependent care flexible spending account; 401(k) plan; voluntary life/short term disability/whole life/term life/accident and critical illness coverage; employee assistance program; sick leave in accordance with regulation. Benefits may be subject to generally applicable eligibility, waiting period, contribution, and other requirements and conditions.
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