ENROLLMENT SPECIALIST (BACK OFFICE)

About OpenLoop OpenLoop was co-founded by CEO, Dr.
Jon Lensing, and COO, Christian Williams, with the vision to bring healing anywhere.
Our telehealth support solutions are thoughtfully designed to streamline and simplify go-to-market care delivery for companies offering meaningful virtual support to patients across an expansive array of specialties, in all 50 states.
Our Company Culture We have a relatively flat organizational structure here at OpenLoop.
Everyone is encouraged to bring ideas to the table and make things happen.
This fits in well with our core values of Autonomy, Competence and Belonging, as we want everyone to feel empowered and supported to do their best work.
Job functions Responsibilities and essential functions for the Enrollment Specialist include.
Responsible for managing the process of adding new healthcare providers to an insurance company's network, ensuring all necessary documentation is complete and compliant with regulations, while acting as the primary point of contact for providers throughout the enrollment process, including verifying their credentials, eligibility, and contractual agreements.
Provider application intake and processing.
Receiving and reviewing provider applications, including necessary documentation like licenses, certifications, and practice information.
Process and review group/provider enrollment applications for Commercial and government payers, with specific focus on Medicare/Medicaid.
Credentialing verification.
Contacting relevant organizations to verify provider credentials, including medical school graduation, board certifications, and malpractice insurance Data entry and management.
Accurately inputting provider information into the company's database, maintaining updated records, and tracking enrollment status, including CAQH.
Compliance checks.
Ensuring all provider applications adhere to state and federal regulations, including HIPAA and Medicare guidelines.
Communication with providers.
Addressing provider inquiries regarding enrollment status, required documentation, and billing procedures.
Follow-up.
Proactively reaching out to providers to gather missing information or address outstanding issues during the enrollment process.
System management.
Utilizing provider enrollment software to manage applications, track progress, and generate reports.
Other duties as assigned.
Qualifications and requirements Required 1+ years of experience in customer service, back office or operational areas in US companies related to the health system (required).
1+ year experience in healthcare Knowledge of the US healthcare system, physician insurance/credentialing especially Medicare/Medicaid, provider enrollment environment (desired).
Knowledge of G-Suite, Slack and Jira.
Strong understanding of healthcare industry regulations and billing practices.
Excellent communication and interpersonal skills to interact effectively with providers and internal stakeholders.
Detail-oriented with the ability to handle complex administrative tasks and manage multiple priorities.
Experience in healthcare administration, provider relations, or insurance industry preferred.
Problem solving and organization skills.
Go-beyond, takes initiative on tasks.
Fluency in English (C1) and excellent written and verbal communication skills.
Available to work 100% on site.
Desirable skills Technical or Professional career related with Business Administration, Industrial Engineer, etc.
Experience using ticket management softwares like Jira.
Our Benefits In addition to competitive salaries, this role includes.
Long term contract under a Peruvian company ID ("Planilla").
You will receive all the legal benefits in Peruvian soles (CTS, "Gratificaciones", etc).
Monday - Friday workdays, full time (9 am - 6 pm).
Unlimited vacation days.
EPS healthcare covered 100% with RIMAC --Because you, too, deserve access to great healthcare.
AFP retirement plan—to help you save for the future.
We will assign a computer in the office so you can have the best tools to do your job.
You will have all the benefits of the Coworking space located in Lima - Miraflores (Free beverage, internal talks, bicycle parking, best view of the city).
Sound like a good fit? We’d love to meet you! Apply now to OpenLoop Disclaimer.
This position is also open for candidates with some kind of disabilities that are part of the CONADIS list.
Coworking is adequate for people with special mobility needs.