Maven Wise, LLC is recruiting for a Provider Enrollment Specialist with exceptional experience in managing credentialing/enrollment and validation for highly sensitive confidential information for a globally recognized Life Sciences organization located in the Santa Clarita Valley. Hybrid/Remote opportunity available. Must be able to commute to Valencia, CA 91352

Here's your day-to-day:

• Completes the enrollment/credentialing/validation process in a timely manner for providers.
• Handles and protects highly sensitive and confidential information.
• Resolves enrollment issues through collaboration with health carriers, management, legal and others, as identified.
• Maintains a positive working relationship with health insurance carriers and plays an active role in explaining and educating them about the organization and the services provided.
• Negotiates acceptable reimbursement in accordance with company standards.
• Maintains updated information from various sources including state licensing boards, malpractice insurance companies and health carriers. Identifies and resolves problems by interpreting, analyzing, and researching data.
• Proactively obtains updated revalidation prior to expiration
• Creates, develops, and maintains good records and/or utilizes department and health carrier software that supports the enrollment process.
• Coordinates fee schedule updates/uploads and validates that all fee scheduled are accurate and correct from payment to booking revenue.
• Communicates updated payer enrollment information including payer provider numbers enrollment status and fee schedules in a timely manner while fostering good working relationships with all departments.
• Accurate and timely reporting of any KPI’s, updates or any other information deemed necessary by management.
• Continuously searches for process improvements to achieve accuracy and efficiency.
• Health carrier website and password updates.
• Performs other duties as assigned or required.

Here are your credentials:

• Associates Degree or Bachelor's Degree or related experience
• Knowledge of health insurance laws and regulations
• 2 years of credential/provider enrollment
• Exceptional written and oral communication
• Expertise in health insurance, carrier provisions, plans, benefits and coverage.

Job Types: Full-time, Contract, Temporary

Pay: $28.00 - $30.00 per hour

Schedule:

• Monday to Friday

Education:

• High school or equivalent (Required)

Work Location: Hybrid remote in Los Angeles, CA 90001

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