Job Description
City/State Tallahassee, FL Work Shift First (Days) Overview: Sentara Health Plan is currently hiring a Provider Data and Enrollment Specialist I- Remote in FL and VA! Status: Full-time, permanent position (40 hours) Standard work hours: 8am to 5pm EST, M-F Location: Remote in Florida and Virginia. Overview The primary role of the Provider Data Enrollment Specialist I is to ensure the data integrity of provider records entered and maintained in the credentialing and/or payment systems. This position may be responsible for all aspects of ensuring accurate and timely processing of provider setup to initiate credentialing, provider record updates and edits, processing provider terminations, and researching and resolving provider setup issues in the applicable systems. This data maintenance will support network adequacy and growth, regulatory reporting, provider directories, as well as downstream systems and processes. Education HS - High School Grad or Equivalent REQUIRED Experience Minimum of 1-year experience in healthcare insurance working with provider, network, or contract data; or a combination of education and experience, which would provide an equivalent background REQUIRED Strong Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint, etc.) Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees. Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals. We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all to help our members improve their health. Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth. Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve! To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-97246 Talroo-Health Plan Keywords: Managed Care, MCO, Healthcare, Health Plan, Health Insurance, Remote, Virginia, Provider Data, Enrollment, Claims, Florida Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.