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Provider Enrollment Specialist

Job Location: TX - Austin

Regional Description: Southwest

Número da Vaga: 00607775

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- Job description

Join Accenture and help transform leading organizations and communities around the world. The sheer scale of our capabilities and client engagements and the way we collaborate, operate and deliver value provides an unparalleled opportunity to grow and advance. Choose Accenture, and make delivering innovative work part of your extraordinary career.

 

People in our Client Delivery & Operations career track drive delivery and capability excellence through the design, development and/or delivery of a solution, service, capability or offering. They grow into delivery-focused roles, and can progress within their current role, laterally or upward.

 

Business Process Delivery professionals execute repeatable core business processes and/or technical transactions with a focus on efficiency, first-time quality and overall continuous process improvement.

 

Job Description

 

The Provider Enrollment Specialist process enrollment and credentialing of providers for state Medicaid program. 

 

Key Responsibilities:

  •  Interact professionally with providers and ancillary staff to provide appropriate and timely response to inquiries and concerns regarding provider enrollment and file maintenance for Medicaid programs including dental, vision, ambulance, physicians, nurses and all other provider types
  • Process to completion 100 of assigned applications utilizing documented work instructions, daily and meet minimum daily quotas.
  • Data entry of paper applications with validation of provider submitted enrollment information to insure the enrollment application meets the minimum standards
  • Compose and send deficiency letters to notify providers of incomplete inaccurate applications revising existing deficiencies and sending corrected letters based on QA audits as required.
  • Respond to inquiries regarding status of applications received
  • Research and contact providers to resolve enrollment application deficiencies
  • Send out provider applications, forms and other provider correspondence as requested
  • Adhere to Quality Assurance program in order to improve daily processing of applications and file maintenance transactions with a minimum quality score of 98
  • Makes recommendations to management to improve efficiency effectiveness of current manual processes through systemic modifications
  • Maintain strict confidentiality of information and job files as dictated by current HIPAA requirements
  • Respond to Tier III escalations and or file maintenance requests as assigned within the specified due dates
  • Flexibility to work overtime as dictated by daily production inventory requirements
  • Perform other duties as assigned by leadership.

Basic Qualifications

  • High School diploma or GED
  • Minimum of 1 year of experience enrolling and credentialing healthcare providers

Applicants for employment in the US must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the United States and with Accenture. 

 
Candidates who are currently employed by a client of Accenture or an affiliated Accenture business may not be eligible for consideration.
 
Accenture is an EEO and Affirmative Action Employer of Females/Minorities/Veterans/Individuals with Disabilities.
 
Equal Employment Opportunity
All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by federal, state, or local law.
 
Job candidates will not be obligated to disclose sealed or expunged records of conviction or arrest as part of the hiring process.
 

Accenture is committed to providing veteran employment opportunities to our service men and women.

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