Payor Enrollment Specialist Full Time
Tasks
- Assist with credentialing licensing and privileging
- Communicate with payers and providers for enrollment information
- Complete payer enrollment application follow up
- Coordinate ERA EDI EFT enrollment channels
- Load enrollment approvals and effective dates
- Maintain CAQH PECOS profiles
- Maintain payer directories rosters and practice addresses
- Maintain provider information confidentiality
- Monitor enrollment worklists for claims denials
- Perform day to day provider enrollment follow ups
- Perform payer e credentialing and revalidations
- Resolve enrollment and credentialing issues
- Respond to enrollment services dashboard tasks
- Terminate payer enrollment for providers
- Update National Provider Identifier files
- Update credentialing and enrollment requirements
- Use electronic billing system for enrollment data
Perks/Benefits
- N/A
Skills/Tech-stack
Account Receivable | Account Receivable Monitoring | CAQH | Credentialing | Directory management | EDI | EFT | ERA | Electronic billing | National Provider Identifier | PECOS | Provider Directory Management | Provider directory | Revalidation | Worklist management
Education
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