Senior Managed Care Specialist-(PROVIDER ENROLLMENT)
Core
Managing provider enrollment and credentialing for hospital-employed or contracted physicians into insurance programs, including State Medicaid.
Role type
Senior Managed Care Specialist (Provider Enrollment)
Builds
Enrollment of providers into contracted insurance programs
Domain
Healthcare administration / Insurance
Deliverable
client delivery
Required skills
Provider enrollment, Credentialing, Claims management, Payor issue resolution, Denial management, Compliance monitoring
Preferred skills
EPIC, CREDENTIALSTREAM, Prior provider enrollment experience
Responsibilities
Execute managed care tasks including provider enrollment and credentialing, coordinate with internal and external teams, support payer communications, manage denial issues, monitor delivery for compliance
Seniority
Senior, hands-on IC
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