Provider Enrollment Specialist

• Company Intro At American Vision Partners (AVP), we partner with the most respected ophthalmology practices in the country and integrate best-in-class management systems, operational infrastructure, and advanced technology to provide the highest quality patient care possible.
• Our practices include Barnet Dulaney Perkins Eye Center, Southwestern Eye Center, Retinal Consultants of Arizona, M&M Eye Institute, Abrams Eye Institute, Southwest Eye Institute, Aiello Eye Institute, Moretsky Cassidy Vision Correction, Wellish Vision Institute, West Texas Eye Associates and Vantage Eye Center.
• We are focused on building the nation’s largest and most comprehensive eye care practices and currently operate more than 100 eye care centers in Arizona, New Mexico, Nevada, California and Texas – including 25 ambulatory surgical centers.At AVP we value teamwork, providing exceptional experiences, continuous improvement, financial strength, and hard work.
• We are committed to providing best-in-class patient care, pioneering research and technology, and most importantly, rewarding and recognizing our employees!
• Overview this is an in-Office position based in tempe, az monday through friday.
• This is not a remote position.
• As a Provider Enrollment Specialist, you'll be responsible for assisting with the administration of the provider enrollment process for assigned new and existing providers.
• You'll also be responsible for assisting in obtaining and maintaining information essential to complete the credentialing/re-credentialing process.

Responsibilities

Prepares and submits enrollment applications for practitioners/group practices and facilities Initiates and manages new enrollments until providers are enrolled with all assigned payers Follows up on the status of enrollment applications as well as maintaining all updated needed using Smart Sheets Using Smart Sheets, keeps detailed log of all pending and completed tasks Maintains/Updates/Communicates enrollment status reports and updates on regular basis Maintains/updates Wybtrak/CAQH and other provider portals on regular basis Maintains managed care insurance paperless files for assigned practitioners Frequently contacts practitioners, insurance representatives and other provider staff for compilation of provider data Complies with NCQA, Medicare and Medicaid standards, department procedures and guidelines Maintains strict confidentiality, adheres to all HIPAA Guidelines/Regulations Familiar with Medicare, Medicaid, commercial fee schedules; assist Director in updating fee schedules for updates to Next Gen EPM Works effectively and proactively to resolve issues Performs all other duties as assigned