Provider Data and Enrollment Specialist I
City/State
Richmond, VAWork Shift
First (Days)Overview:
Provider Data and Enrollment Specialist I
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
High School diploma or equivalent is required
Certification
- No certification is required
Experience
- Previous experience in Managed Care/HealthCare strongly preferred
- Related experience or skill sets in the following areas would be preferred:
- Payment Systems, Credentialing, Medicare, Managed Care (such as Blue Cross/Blue Shield)
Position work schedule 8am-5pm.
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.