Anticipated End Date:

2024-08-15

Position Title:

SCA Provider Enrollment Rep Senior – Part B

Job Description:

SCA Provider Enrollment Rep Senior – Part B

Locations:  Elevance Health supports a hybrid workplace model with pulse point sites (major office) used for collaboration, community, and connection. This position will be primarily virtual, however will be based within 50 miles of an Elevance Health PulsePoint locations listed.

National Government Services is a proud member of Elevance Health’s family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs.

Pay: the pay for this position varies by location, is set by the government, and is non-negotiable.

The pay is as follows:

• Indianapolis, Indiana - $23.85
• Hingham, Massachusetts - $25.04
• Baltimore, Maryland - $25.04
• South Portland, Maine - $22.65
• Syracuse, New York - $23.85
• Harrisburg, Pennsylvania - $22.65
• Denison, Texas - $22.65

The SCA Provider Enrollment Rep Senior is responsible for accurate, timely maintenance of complex provider information and synchronization of data on all claims and provider databases including expertise on business requirements for multiple business regions for Part B provider enrollment applications.

How you will make an impact:

• Leads the department in problem identification, analysis, and resolution for multiple system provider database issues.
• Participates in system testing and analysis in support of new functionality, new system processes, and business rules changes that will impact Part B provider enrollment processes.
• Validates the data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
• Researches and resolves complex exceptions and error reports, determine regional/cap/business indicators for multiple business areas to assure accurate reimbursement based on provider contract and area fee schedules.
• Interprets update requests and coordinates with internal and external customer to clarify and complete.
• Determines training needs and trains less experienced associates and outside customers on multiple provider database systems and business requirements.

Minimum Requirements:

• Requires a High School diploma or equivalent and a minimum 3 years experience in claims processing, provider relations/customer service and credentialing and a minimum 1 year provider enrollment experience; or any combination of education and experience which would provide an equivalent background.
• This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years.

Preferred Skills, Capabilities and Experiences:

• Prior experience working with Medicare guidelines
• Strong written and oral communication skills, problem solving skills, and strong attention to detail preferred.
• The ability to research and troubleshoot complex issues highly preferred.

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $23.85

Locations:  New York

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company.  The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Job Level:

Non-Management Non-Exempt

Workshift:

1st Shift (United States of America)

Job Family:

SCA > SCA Wage Determination

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance.