Provider Enrollment Coordinator

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Introduction and Overview:
This role will report to our Provider Enrollment Supervisor

Responsible for reviewing and processing credentialing applications and supporting documentation for the purpose of enrolling individual physicians and physician groups in Medicaid and Medicare. Responsible for accurate and timely processing of Part B provider enrollment applications.

 
Roles & Responsibilities: 

• Ability to work within a deadline-intense environment.
• Interact professionally with providers and staff representatives to provide information on any necessary documentation required for processing.
• Plan, prioritize, organize and complete work to meet established objectives.
• Track and follow up with providers for timely return of all required documents and applications.
• Assists in synchronization of data among multiple systems
• Validates the data to be housed on provider databases and ensuring adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing
• Display in-depth knowledge of and execute all standard operating procedures (SOPs) as well as communicating issues, trends, concerns and suggestions to leadership.
• In-depth working knowledge of the various payer applications associated and the workflow process.
• Ensure all workflow items are completed within the set turn-around-time, meeting quality expectations.

Basic Qualifications: 

• 3 years of experience in a centralized credentialing office and direct provider enrollment experience, such as credentialing or file maintenance, preferred with experience in Word and Excel
• Knowledge of health plan and governmental payer credentialing, enrollment and requirements acquired through completion of a CPCS certification course, or sufficient job-related experience with intent to pursue certification.
• Knowledge of PECOS and State Medicaid Enrollment applications

Preferred Qualifications: 

• Experience with MD Staff credentialing and enrollment software preferred
• Knowledge of standards interpretation as related to NCQA

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$17.00 - $28.46

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

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