Provider Enrollment Specialist III - 91697

Provider Enrollment Specialist III - 91697

The compensation range listed reflects the range Northern Light Health anticipates relying on in setting the wages for the position. The range may not necessarily include all additional compensation elements available, such as differentials, incentive programs and benefits.

The Provider Enrollment Specialist III is responsible for performing all provider and facility enrollment and re-credentialing activities required of all NLH contracted commercial and governmental payers. The Specialist will support the maintenance of provider CAQH profiles, partner closely with the revenue cycle and operational leaders to resolve enrollment barriers, follow-up with payers to eliminate risk associated with enrollment gaps, and monitor held claims to ensure timely action.

The specialist serves as a senior resource for complex enrollment issues and may lead or participate in payer enrollment issues or enrollment initiatives, process improvement efforts, regulatory compliance activities, system implementations, and other special projects related to payer enrollment operations.

Responsibilities include practitioner and facility enrollment, enrollment maintenance, policies, procedures and documents, operations, financial and quality management, CVO operations, miscellaneous and other tasks, and other duties.

Competencies and skills include achieving results, adaptability, emotional intelligence, developing self and others, effective communication, exercising sound judgment and decision making, fostering innovation, influencing and inspiring, spreadsheet application, word processing, email application, presentation software, MS Teams, multi-line phone, scanner, photocopier, fax, internet, experience with operating a network, public speaking, seeking process improvement and applying system thinking, serving others, troubleshooting, behaving with integrity and building trust, cultivating respect, fostering accountability, and practicing compassion.

Education: Required Bachelor's Degree. In lieu of education, two years of experience is required per year of required education, exclusive of the minimum experience identified above.

Required Experience: 5 year/years of relevant work experience.

Working Conditions: Work with computers, typing, reading or writing.

As an integrated health delivery system serving Maine, Northern Light Health is raising the bar with no-nonsense solutions that are leading the way to a healthier future for our state. Our care teamin hospitals, primary and specialty care practices, long-term and home healthcare, behavioral healthcare, and ground and air medical transport and emergency careare committed to making healthcare work for you: our patients, communities, and employees.

Questions? Contact Talent Acquisition: phone: View phone number on click.appcast.io email: View email address on click.appcast.io

Equal Opportunity Employment

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, disability status, gender, sex, sexual orientation, gender identity, ancestry, protected veteran status, national origin, genetic information or any other legally protected status.