Provider Enrollment Specialist - Baton Rouge, LA - Hybrid

$33,500 - $47,900/Yr

Gainwell Technologies - Baton Rouge, LA

Full-time - Entry Level

Hybrid - Baton Rouge, LA

Professional, Scientific, and Technical Services

About the position

The Provider Enrollment Specialist at Gainwell plays a crucial role in enhancing healthcare services by managing provider enrollment and credentialing processes. This hybrid position in Baton Rouge, LA, involves responding to customer inquiries, processing requests, and ensuring data integrity while collaborating with team members to improve operational efficiency. The role is essential in supporting the company's mission to improve the health and well-being of vulnerable communities through effective provider management.

Responsibilities

• Answers telephones and responds to moderately complex customer questions and/or forwards calls to appropriate personnel.
• Researches customer inquiries and responds to appropriate parties in a timely manner.
• Records calls, processes requests, and updates account history with results of inquiry to include proper documentation.
• Processes and distributes incoming and outgoing mail for multiple clients in accordance with established service level agreements.
• Performs data entry and matches documents to appropriate accounts to verify up-to-date and accurate information.
• Interfaces with team personnel, management, and customers regarding customer service issues.
• Reviews client reports on a weekly basis to ensure data integrity; prepares and submits reports to management.
• Reviews and recommends modifications to procedures and workflow as necessary to ensure efficient and effective processing of transactions.
• Monitors daily transactions to ensure policy and procedures are in accordance with service level agreements.

Requirements

• Minimum of 1 year of experience in provider enrollment, credentialing, or a similar role within the healthcare or medical insurance industry.
• Strong understanding of medical insurance processes, including Medicare, Medicaid, and commercial insurance carriers.
• Familiarity with provider enrollment and credentialing requirements is essential.
• Advanced proficiency in healthcare management software, databases, and general office applications (e.g., Microsoft Office Suite).
• Exceptional accuracy and thoroughness in managing complex documentation and ensuring compliance with regulatory standards.
• Capability to analyze data, identify trends, and troubleshoot issues related to provider enrollment and credentialing.
• Call center experience.

Benefits

• Generous, flexible vacation policy
• 401(k) employer match
• Comprehensive health benefits
• Educational assistance
• Leadership and technical development academies