Provider Enrollment Specialist
Core
Manage provider enrollment and credentialing for ophthalmologists and optometrists across multiple payers and facilities.
Role type
Provider Enrollment Specialist
Builds
Provider enrollment status and credentialing records for hospitals and facilities
Domain
Healthcare administration / Insurance enrollment
Required skills
Provider data management, Credentialing processes, Payer enrollment (Medicare/Medicaid/Commercial), Database maintenance, CAQH/NPPES management, Regulatory compliance (HIPAA), Microsoft Office proficiency, Insurance payer knowledge
Preferred skills
Problem solving, Customer service, Time management, Technology adaptability
Responsibilities
Enroll providers with payers, Complete credentialing documentation, Maintain provider databases, Update CAQH and NPPES, Contact payer representatives, Track enrollment expirables, Manage hospital appointments