Provider & payer Enrollment Specialist (New Jersey)

The Enrollment Specialist will be the primary contact for the New Jersey Market’s Enrollment Department for all Privia independent providers and care centers, and responsible for all aspects of managing the payer enrollment process. 

Primary Job Duties:

• The Enrollment Specialist will take steps necessary to enroll all new groups and providers with the contracted payers in the Florida market, including all commercial and federal payers.
• The Enrollment Specialist will manage all payer data in CredentialStream for both the group and the individual providers.
• The Enrollment Specialist will take steps necessary to investigate all claims/enrollment related issues or questions with the care centers.
• Work within AthenaOne EMR to resolve inbound claims related inquiries.
• Partners with internal and external partners in the onboarding process including the National Credentialing Team, Implementation Team, and Operations Consultants.
• Resolution of Salesforce cases and management of issues and the team resolving the cases is a key element in this role.
• Act as liaison between Enrollment Department and both internal and external stakeholders
• Other duties as assigned