Status: Full-time, permanent position (40 hours)
Standard work hours: 8am to 5pm EST, M-F
Location: Remote in Florida and Virginia.
Overview
The primary role of the Provider Data Enrollment Specialist I is to ensure the data integrity of provider records entered and maintained in the credentialing and/or payment systems. This position may be responsible for all aspects of ensuring accurate and timely processing of provider setup to initiate credentialing, provider record updates and edits, processing provider terminations, and researching and resolving provider setup issues in the applicable systems. This data maintenance will support network adequacy and growth, regulatory reporting, provider directories, as well as downstream systems and processes.
Education
HS - High School Grad or Equivalent REQUIRED
Experience
Minimum of 1-year experience in healthcare insurance working with provider, network, or contract data; or a combination of education and experience, which would provide an equivalent background REQUIRED
Strong Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint, etc.)
Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.
Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals.
We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all to help our members improve their health.
Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.
Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!
To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-97246
Talroo-Health Plan
Keywords: Managed Care, MCO, Healthcare, Health Plan, Health Insurance, Remote, Virginia, Provider Data, Enrollment, Claims, Florida