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The Provider Enrollment Specialist provides support and completion of provider enrollment applications for governmental and non-governmental payers for MPOWERHealth/Acquisition Billing clients.
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Minimum of one year paralegal/legal assistant experience, preferably in healthcare environment or experience in Medicare or Medicaid provider enrollment or private payer enrollment/credentialing.
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Provider Enrollment Specialist (PESC) certificate. Applies advanced knowledge of regulatory and accreditation standards such as The Joint Commission (TJC), National Committee for Quality Assurance (NCQA), Centers for Medicare & Medicaid Services (CMS), Health Resources and Services Administration (HRSA) to ensure continued compliance in all matters pertaining to professional staff services.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Job Description Educational/Enrollment Process Educate and provide assistance to qualified individuals with applying for coverage through the NY State of Health Marketplace in a Qualified Health Plan (QHP) and insurance affordability programs such as Medicaid and Child Health Plus. Assist consumers/applicants with calling the NY State of Health Customer Services Department for assistance with enrolling and/or providing verification documentation.
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About NYC Health + Hospitals MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
$50,000Full-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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The Community Medicaid Outreach Specialist provides essential face-to-face and virtual /telephonic and outreach enrollment services, focusing on assisting New York Medicaid recipients.
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The Enrollment Coordinator must ensure that all assignments are completed accurately and in a timely manner in accordance with NYSDOH Medicaid guidelines, MLTC provider regulations, and agency policies and procedures.
$38,545.53 - $48,181.92 a yearPart-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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As part of a team including an Enrollment Coordinator, Medicaid Specialist, and department manager, the Outreach Coordinator identifies and cultivates new relationship opportunities that will support the PACE program’s goals for enrollment growth.
Full-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Researches and resolves assigned Medicaid Provider Enrollment and Site Visit related issues and documents their findings to Program Administrator and Program Operations Administrator. This position is responsible for planning and conducting in-house and on-site New Provider Enrollment Reviews and validating re-enrollment reviews of current Medicaid providers to determine if they meet Medicaid provider enrollment requirements.
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Three (3) to five (5) years of credentialing and/or provider enrollment leadership experience with physicians, Advance Practice Clinicians (APCs), behavioral health, and/or allied providers, in a fast-paced health care environment (hospital, provider group, health plan) – Required.
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Perform other related administrative ECAP Department assignments as required Lead ECAP huddles Coordinate On Boarding Task Force Meetings Coordinate meetings with NYPH and Non-NYPH Program Coordinators/Administrators Enrollment of 2 Factor Authentication via Imprivata for prescribers EPIC approvals – verify credentialed provider’s DEA in Cactus EPIC/IT Ticket Submissions for GME InRotators and OnCalls.
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Assist individuals and families with assessing program affordability, eligibility requirements, education about programs, and enrollment in various benefit programs including but not limited to Medicaid, WIC, and SNAP. Facilitate problem-solving of consumer grievances, complaints, or questions about programs and services Essential Function Yes Percentage of Time 60 Job Duty Develop relationships with community leaders in the target area to facilitate program functioning.
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MINIMUM QUALIFICATIONS + APRN + Psychiatric certification EDUCATION/EXPERIENCE/CERTIFICATION: + NP License in the state of KY; hold DEA + 2 year of inpatient acute psychiatric experience minimum + Experience with Involuntary Holds (Mental Inquest Warrant) preferred DESIRED + Kentucky Medicaid enrollment.
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Assists with benefits administration, including enrollment, ASRS verification and employee communication. AHCCCS is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for excellence in workplace effectiveness and flexibility.
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Responsible for working with pre-enrollees, participants, caregivers, staff and external regulatory staff (such as Mass Health) and NaviCare NHC pre-enrollees to assure that enrollment in the Medicare and Medicaid systems is accomplished accurately and efficiently with appropriate information entered in the FCHP systems.
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