20/20NOW gives optical retailers the ability to offer patients Ocular Tele-Health eye exams with live doctor consultations so they can buy their new glasses and contacts the same day. Provide patients with walk-in exam availability, any day and time the optical is open, with tele-optometry.

Roles & Responsibilities:

• Work with our customers to confirm current enrollment with payers and specific plans which are needed.
• High level knowledge of CAQH data base, requirements, maintenance, and attestation
• Working in conjunction with HR and Licensing to onboard new providers timely and gather all necessary information
• Work with HR, Licensing, VP of Operations, Billing, CAQH and payors when terming a provider
• Obtain payer information including payer numbers, specific plans and contact information. Prioritize payers and communicate timelines with customer, sales, and management.
• Initiate the enrollment process of new locations and newly licensed providers, collaborating with internal and external customers and providers to prepare and submit provider enrollment applications.
• Work directly with Licensing to obtain all doctors current state license, communicate the need for updated licenses, maintain shared folders and CAQH with current licensure
• Update dashboard with statuses on enrollment and follow up with all payers to avoid any possible delays.
• Maintain list of providers and payers for each location. Identify existing locations where providers need to be added and which payers.
• Prepare, submit, and follow up with payers to confirm providers have been added. Submit provider changes to payers and ensure re-verification process has been completed.
• Maintain and prioritize requests for additional payers from existing locations, prepare applications and submit.
• Properly submit PECOS/Medicare/Medicaid enrollment applications
• Timely creation of logins to portals for new payers and confirmation portal set up is complete. Maintain login sheets for each location with all payers and credentials. Provide initial login sheets to locations and onsite technicians and VP of Operations. Update provider logins and location credentials as needed and distribute to locations and billing company
• Direct support contact for payer questions from managed locations, onsite technicians, subleases, sales, and billing company with timely follow up/resolution.
• Maintain high level of confidentiality and security when communicating electronically
• Timely, professional and through responses to all inquiries from internal and external sources
• This involves attention to detail, accurate and timely entry of provider data including contact information, status changes, and ensuring that verification of all required credentialing criteria has been completed in accordance with all policies and other applicable standards. Keep management abreast of changes to enrollment which will impact business operations.

Qualifications:

• 1-3 years’ experience in Provider Enrollment Relations
• Understanding and knowledge of the credentialing and provider enrollment process with commercial payers
• Strong computer skills including Microsoft Word, Excel, PDF, Share Drives, Docusign, Monday, Zoom, Outlook Email and Calendar
• Must be able to organize and prioritize work and manage competing priorities.
• Excellent verbal and written communication skills
• Ability to establish and maintain effective working relationships with providers, management, staff, billing company and customers
• Strong Customer Service Skills
• Exhibits ability to learn and apply new skills
• Instills cooperation and collaboration amongst team.
• Teamwork – contributes to building positive team spirit, supports everyone’s efforts to succeed.
• Quality – Demonstrates accuracy and thoroughness; applies feedback to improve performance; monitors own work to ensure quality
• Personable, articulate, motivated, and an eager personality
• Multi-tasker and organized
• Strong written and verbal communication skills

Benefits:

• We offer comprehensive benefits package including medical/dental/life, Employer 401K match, Employer paid life insurance, voluntary benefits and much more.