Provider Enrollment Specialist
Core
Ensures accurate data entry for demographic and financial information, researches complex problems, and manages the enrollment/billing process for provider accounts.
Role type
Provider Enrollment Specialist
Builds
Enrollment and billing processes for provider accounts
Domain
Healthcare / Managed Care Operations
Required skills
Payor credentialing applications, Health plan knowledge (Managed Care, Medicare, Medicaid, Workers Comp), Credentialing database management, CAQH database proficiency, Multi-Tax ID entity credentialing, High-volume application processing, MS Word/Excel/Access
Preferred skills
Established relationships with health plan credentialing reps, Project management, Customer service orientation
Responsibilities
Prepare and process credentialing applications for all payor types, Meet company turnaround times and credentialing goals, Work various work queues and assigned duties
Seniority
Mid-level, autonomous IC