Provider Enrollment Rep II - Iowa Medicaid

• Position is eligible for Remote / Work from Home opportunity

Department: Provider Enrollment - Iowa Medicaid

Talent Partner: Elizabeth Fleming

Telecommuting Eligible: Yes

Job Grade: N12

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Job Title

Provider Enrollment Representative II

Job Summary

The Provider Enrollment Representative II completes routine enrollment tasks in support of the provider enrollment team. This position researches and controls incoming applications and correspondence to ensure the work is properly categorized. This position reviews and processes a high volume of prospective provider enrollment applications

Key Performance Indicators

• Attention to detail and accuracy

• Strong interpersonal communication skills

• Organization, time management, and critical thinking skills

Essential Functions

Key Duties/Responsibilities/Accountabilities

• Researches and controls incoming applications and correspondence to ensure work is properly categorized

• Enters data into internal document management and workflow systems

• Provides quality check on the provider enrollment data and enters application information into claims processing systems

• Manages inbound/outbound online FAX queues to and from providers

• Quality assurance checks of claims processing system enrollment data

• Creates and mails notification letters

• Completes application returns and/or application acknowledgement process

• Supports other enrollment functions such as status calls, basic data entry, special mailings, etc.

• Reviews, researches, and processes provider enrollment applications abiding by contract regulations, internal policies, and guidelines

• Coaches providers through the enrollment process and provides inbound phone support

• Initiates requests for information to complete the online enrollment process

• Verifies credentialing information and completes fraud detection and prevention

• Provides support and guidance to Provider Enrollment Representative I staff

• Maintains detailed knowledge of all enrollment applications

• Utilizes resourceful thinking for continuous process improvement

Non-Essential Duties and Functions

• Supports team on special projects and assignments

• Other duties as assigned

• Special projects as assigned

Minimum Qualifications

• High School diploma or GED

• 12 months' clerical experience

• Advanced computer skills, keyboarding, and data entry skills

• Experience with computer programs such as: Microsoft Word, Excel, Access, Outlook and SharePoint

Preferred Qualifications

Above requirements and the following:

• Knowledge of provider enrollment workload definitions, enrollment terminology, enrollment forms, and basic regulations, policies, and procedures

• Proficient in Microsoft Office Applications

• 18 months' provider enrollment experience

Environment and Cognitive/Physical Demands

• Office Environment

• Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve

• Requires prolonged sitting and telephone use

• Requires the use of office equipment such as computer terminals, telephones, copiers and printers

• Infrequent lifting to 15 pounds

• Infrequent stooping

Segregation of Duties

Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to: Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian Compliance Program and any other applicable laws, rules and regulations.

Statement of Other Duties

This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions. Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or management.

Total Rewards Package:

Health, Dental and Vision Insurance, Voluntary Insurance Plans, Health Savings and Flexible Spending Accounts, 401k and Company Match, Company-paid Life Insurance, Education Assistance Program, Paid Sick Leave, Paid Holidays, Increasing PTO Accrual Plan, Medical/Parental/Disability Leave, Workers Compensation, Retiree Benefits, Severance Package, Employee Assistance Program, Financial and Health Wellness Benefits, Casual Dress, Open Office Setting, and Online Learning System.

CMS Access Compliance and Regulation Contingency Statement

Some positions require compliance with (i) federal and agency specific regulations and related clauses included in Noridian's prime contracts with the Government, (ii) background checks, and (iii) eligibility for a government-issued identification card.

Equal Employment Opportunity

Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities as well as Sexual Orientation or Gender Identity.

Below is the salary range for potential new hires.

Salary Range: $17.20 - $23.88 per hour

Other Compensation: Incentive Plan

This job will be closed 05/08/2024 at 8:00AM CST. No further applications will be considered.