At American Vision Partners (AVP), we partner with the most respected ophthalmology practices in the country and integrate best-in-class management systems, operational infrastructure, and advanced technology to provide the highest quality patient care possible. Our practices include Barnet Dulaney Perkins Eye Center, Southwestern Eye Center, Retinal Consultants of Arizona, M&M Eye Institute, Abrams Eye Institute, Southwest Eye Institute, Aiello Eye Institute, Moretsky Cassidy Vision Correction, Wellish Vision Institute, West Texas Eye Associates and Vantage Eye Center. We are focused on building the nation’s largest and most comprehensive eye care practices and currently operate more than 100 eye care centers in Arizona, New Mexico, Nevada, California and Texas – including 25 ambulatory surgical centers.
At AVP we value teamwork, providing exceptional experiences, continuous improvement, financial strength, and hard work. We are committed to providing best-in-class patient care, pioneering research and technology, and most importantly, rewarding and recognizing our employees!
**THIS POSITION IS NOT REMOTE! THIS IS ONSITE IN TEMPE, ARIZONA, MONDAY THROUGH FRIDAY**
As a Provider Enrollment Specialist, you'll be responsible for assisting with the administration of the provider enrollment process for assigned new and existing providers. You'll also be responsible for assisting in obtaining and maintaining information essential to complete the credentialing/re-credentialing process.
Prepares and submits enrollment applications for practitioners/group practices and facilitiesInitiates and manages new enrollments until providers are enrolled with all assigned payersFollows up on the status of enrollment applications as well as maintaining all updated needed using Smart SheetsUsing Smart Sheets, keeps detailed log of all pending and completed tasksMaintains/Updates/Communicates enrollment status reports and updates on regular basisMaintains/updates Wybtrak/CAQH and other provider portals on regular basisMaintains managed care insurance paperless files for assigned practitionersFrequently contacts practitioners, insurance representatives and other provider staff for compilation of provider dataComplies with NCQA, Medicare and Medicaid standards, department procedures and guidelinesMaintains strict confidentiality, adheres to all HIPAA Guidelines/RegulationsFamiliar with Medicare, Medicaid, commercial fee schedules; assist Director in updating fee schedules for updates to Next Gen EPMWorks effectively and proactively to resolve issuesPerforms all other duties as assigned Qualifications High School Diploma or equivalentAssociate's Degree preferred or - 2 years of office business experience in lieu of Associate DegreeProvider Enrollment Specialist Certificate (PESC) or Certified Provider Credentialing Specialist (CPCS) or similar certification in credentialing, health plan or network management required
2 – 3 years’ experience in Provider Enrollment and Credentialing fields is required for this position
Must have working knowledge in Managed Care and/or Network Management
Proficiency in MS applications including and not limited to credentialing database softwareStrong organizational skills and ability to pay attention to detailExcellent communication skills and problem solving abilities within a team environmentAbility to work independently and prioritize assigned duties within given time framesAbility to establish and maintain effective working relationships with insurance representatives, providers and coworkers Benefits & PerksYour health, happiness and your future matters! At AVP, we offer everything medical and dental insurance, significant eye care discounts, child care assistance, pet insurance, continuing education funds, 401(k), paid holidays plus PTO, Sick Time, opportunity for growth, and much more!
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