MPR Specialists

Come join our GROWING TEAM! We are currently hiring additional team members across ALL teams!

Work Location: in person only in Wichita, KS or Kansas City, MO

You’ll join a team that values your ideas, invests in your growth, and believes you shouldn’t have to choose between doing excellent work and having a life outside of work. Benefits include:

• 28 days of PTO/holidays/mental health/volunteer time in the first full calendar year
• Growth Opportunities
• Cross-Training
• Career Development Program
• Team Member Appreciation
• Flexible Schedules
• Wage amount will be commensurate with experience.

**PROVIDER ENROLLMENT (**PE) SPECIALIST:

Competency

• Knowledge of payer enrollment processes and requirements, including PECOS and CAQH.

• Strong attention to detail, organizational skills, and the ability to manage multiple tasks in a fast-paced environment.

• Demonstrate accuracy, organizational and problem-solving skills.

• Excellent verbal and written communication skills.

• Ability to work independently.

• Maintains confidentiality.

Required Education and Experience

• 3+ years of Provider Enrollment experience preferred.

• Must be working toward PE Certification.

• Experience with CAQH and PECOS.

• Proficient in Microsoft 365.

• Familiar with internet.

• Excellent written and verbal communication skills.

• Experience with credentialing software.

Preferred Education and Experience (Provider Enrollment Specialist III)

• Relevant education and certification a plus.

• 5+ years of experience preferred.

MAIN DUTIES

• Enroll medical providers in health plans.

• Coordinates credentialing data needed for enrollment, contracting, and other related purposes.

• Creation and maintenance of CAQH Application.

• Ongoing monitoring and support of provider documentation including Kansas State or Other State Licensure, DEA, NPI, Certificate of Insurance and other documents as required by the regulatory agencies.

• Complete Third-Party Payer Applications.

• The ability to work with diverse internal and external customers.

• Terminating providers with current practice at the request of the client.

PRIMARY SOURCE VERIFICATION (PSV) SPECIALIST:

Competency

• Knowledge of Initial Appointment, Reappointment and Final Quality processes and requirements, including CMS, TJC, NCQA, URAC, AAAHC, ACHC (HFAP) and DNV.
• Strong attention to detail, organizational skills, and the ability to manage multiple tasks in a fast-paced environment.
• Demonstrate accuracy, organizational and problem-solving skills.
• Excellent verbal and written communication skills.
• Ability to work independently.
• Maintains confidentiality.

Required Education and Experience

• 3+ years of experience preferred.
• Must be working toward NAMSS Certification.
• Experience in working with provider database and running reports.
• Proficient in Microsoft 365.
• Familiar with internet.
• Excellent written and verbal communication skills.
• Experience with credentialing software.

Preferred Education and Experience (PSV Specialist III)

• 5+ years of experience preferred.
• Relevant education and NAMSS certification a plus.

MAIN DUTIES

• Process Initial Appointment Applications.
• Process Locum Tenens Initial Appointment Applications as Requested.
• Process Requests for Additional Privileges.
• Process Telemedicine Applications.
• Process Reappointment Applications.
• Final Quality Review.

DATA INTEGRITY (DI) SPECIALIST:

Competency

• Proficient in Office 365 including SharePoint.

• Database maintenance using SQL and Azure or desire and ability to learn.

• Strong attention to detail, organizational skills, and the ability to manage multiple tasks in a fast-paced environment.

• Demonstrate accuracy, organizational and problem-solving skills.

• Excellent verbal and written communication skills.

• Ability to work independently.

• Maintains confidentiality.

Preferred Education and Experience

• 3+ years of relevant experience preferred.

MAIN DUTIES

• Credentialing Contact Changes.

• Initial Request for Privilege Monitoring.

• Monitor the Data Integrity through Prebuilt Reports.

• Report Assembly.

• Auditor and Process Improvements.

• Provider Enrollment Group Changes.

• SharePoint and other Apps.

• Monthly Dashboards.

• Merge Document Revisions.

• Database Maintenance Assistant.

• Database and Portal Troubleshooting.

• Updates and Upgrades to Custom Software and Portals.

• Code Maintenance and Updates.

• IT Helpdesk.

• Database Training.