Provider Enrollment Specialist
Grow TherapyFull Time
Mid-level (3 to 4 years), Senior (5 to 8 years)
Candidates must have a minimum of 1 year of experience in administrative support, data entry, and healthcare-related background with an understanding of Medicare and Medicaid. A minimum of 1 year of experience in provider data management, provider directory systems, or credentialing systems is required, along with an understanding of healthcare provider types, specialties, or network structures. Experience interpreting reports and data extracts, using multiple computer applications simultaneously, and proficiency in Microsoft Office Programs (Word, Excel, OneNote, PowerPoint) are necessary. A positive, proactive attitude, self-starter mentality with excellent time management and prioritization skills, comfort with process changes, and meeting work-at-home connectivity requirements are also essential.
The Provider Installation Representative is responsible for building forms, typically completed in June and July for the following year. They will input data criteria in the Directory Designer (DD), proof paper directories every 30 days, and submit defects found within directories for correction. Responsibilities also include completing defect closeouts after corrections, reviewing dashboard reports from IT for potential issues, and researching provider information identified by the market and customer service. The role involves collaborating with the Internet Directory Creator (IDC) team and Directories Team Auditors to ensure a positive member experience.
Health insurance provider for seniors and military
Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.