About the Role
The Provider Services Specialist is responsible for the completion of enrollment tasks and the follow-up on credentialing-based holds and denials. The ideal candidate for the position follows the key performance goals as established by Caduceus for its client base of large-scale, multi-specialty healthcare organizations. The Provider Services Specialist is responsible for the escalation of new and existing : fielding, escalating, tracking, and trending payer, provider, or billing platform issues identified by his or her team and communicated to client and Caduceus management.
A Day in the Life
- Demonstrates a thorough knowledge and proficiency in all aspects of provider enrollment in a professional healthcare practice setting.
- Provides support on front end holds and back-end denials with a goal of follow up and resolution.
- Reports on new and existing issues to upper administration.
- Processes tasks from Enrollment Worklist including Credentialing Status, Payer Affiliation, Forms, and Online Enrollments. Assist with EDI, ERA, EFT, and Athena payor portal access
- Updates and maintains all Payer Enrollment groups and statuses as directed by lead or administration.
- Possess a working knowledge and effective navigation of insurance portals including CAQH.
- Acts as liaison with Practitioners, billing management and insurance carriers.
- Performs other assigned duties/tasks.
- Demonstrates mastery of the above essential functions with passing grades in testing environment.
What You Need
- Athena Experience required.
- Bachelor’s degree preferred or equivalent experience in business/healthcare environment.
- 3+ years of applicable experience in credentialing and enrollment. Multi-specialty experience is a big plus.
- Experience working in a medical billing environment where compliance with protected health information and HIPAA compliance is strongly enforced.
- Excellent written and verbal communication skills with superior attention to detail.
- Ability to multi-task under tight timelines with strong administrative and exceptional organizational skills.
- Proficient in Microsoft Office Suite; Word, Excel, PowerPoint, and Outlook.
- Advanced knowledge credentialing databases or reporting systems.
We offer competitive benefits to set you up for success in and outside of work.
Here’s What We Offer
- Generous Paid Time Off: Recharge and relax with 20 days of fixed time off per year, in addition to company holidays—because we believe work-life balance fuels performance.
- Best-in-Class Parental Leave: Spend quality time with your growing family. We offer one of the industry’s most generous parental leave policies to support you during life’s most important moments.
- Recognition & Rewards: We celebrate wins—big and small. Get rewarded with monetary incentives and company-wide recognition for your impact and dedication. Your hard work won’t go unnoticed.
- Comprehensive Insurance Coverage: Stay covered with medical, dental, and vision insurance, plus 100% company-paid short- and long-term disability and basic life insurance. Optional perks include discounted legal aid and pet insurance.
Innovaccer Inc. is an equal opportunity employer. We celebrate diversity and are committed to fostering an inclusive workplace where all employees feel valued and empowered regardless of any characteristic protected by federal, state or local law including, without limitation, race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, medical condition, disability, age, marital status, or veteran status. Innovaccer Inc. participates in the E-Verify program to confirm employment eligibility of all newly hired employees based out of the U.S. and employed by Innovaccer Inc.
For any additional information, please visit the below websites:
E-Verify
Right to Work (English)
Right to Work (Spanish)
Disclaimer:
Innovaccer does not charge fees or require payment from individuals or agencies for securing employment with us. We do not guarantee job spots or engage in any financial transactions related to employment. If you encounter any posts or requests asking for payment or personal information, we strongly advise you to report them immediately to our HR department at px@innovaccer.com. Additionally, please exercise caution and verify the authenticity of any requests before disclosing personal and confidential information, including bank account details.