Provider Enrollment Specialist

Welcome to Highmark Health, where we are committed to improving the health and well-being of our community. We are currently seeking a highly skilled and motivated Provider Enrollment Specialist to join our team. As a Provider Enrollment Specialist, you will play a crucial role in ensuring that our network of healthcare providers is properly credentialed and enrolled with our organization. The ideal candidate will have a strong attention to detail, excellent communication skills, and a passion for helping others. If you are looking for a challenging and rewarding career in healthcare administration, we encourage you to apply for this exciting opportunity.

1. Accurately and efficiently process provider enrollment applications and ensure all necessary documentation is complete and accurate.
2. Maintain up-to-date knowledge of provider enrollment requirements and regulations set by government agencies and third-party payers.
3. Communicate effectively with providers, insurance companies, and internal teams to resolve any enrollment issues or discrepancies.
4. Collaborate with various departments to ensure timely and accurate processing of provider enrollments.
5. Prepare and submit necessary paperwork for credentialing and re-credentialing of providers.
6. Monitor and track provider enrollment statuses and follow up on any outstanding or incomplete applications.
7. Provide excellent customer service to providers and respond to inquiries and concerns in a timely manner.
8. Maintain accurate and organized records of provider enrollment activities and documentation.
9. Participate in quality improvement initiatives to streamline enrollment processes and improve overall efficiency.
10. Adhere to all HIPAA and privacy regulations when handling sensitive provider information.
11. Assist with training and onboarding of new Provider Enrollment team members.
12. Continuously evaluate and suggest improvements to provider enrollment processes.
13. Keep abreast of industry trends and changes in provider enrollment requirements.
14. Maintain a professional and positive attitude while representing Highmark Health to providers and other external stakeholders.
15. Adhere to company policies and procedures and follow all compliance guidelines.

According to JobzMall, the average salary range for a Provider Enrollment Specialist in Pittsburgh, PA, USA is $38,500 - $52,000 per year. This can vary depending on experience, qualifications, and the specific company or healthcare organization hiring for the position.

Highmark Inc. is among the largest health insurers in the United States and the fourth-largest Blue Cross and Blue Shield-affiliated company. Highmark and its diversified businesses and affiliates operate health insurance plans in Pennsylvania, Delaware and West Virginia that serve 5.2 million members. Its diversified health businesses serve group customer and individual health needs across the United States through dental insurance, vision care and other related health businesses. Highmark is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.