Credentialing & Enrollment Specialist
Tasks
- Coordinate information between payers and facilities
- Ensure payor enrollment completion
- Follow health plan certification guidelines
- Maintain provider confidentiality
- Manage provider credentialing recredentialing privileging
- Prepare reports
- Record track credentialing statistics
- Resolve claim denials related to enrollment
- Resolve provider enrollment issues
- Review streamline onboarding workflows
- Support delegated and non delegated health plan requirements
- Track license and certification renewals
- Update provider data in credentialing systems
Perks/Benefits
Skills/Tech-stack
Excel Pivot | Excel Pivot Table | Google Sheets | HIPAA | Hospital Credentialing | MS Excel | Managed care | Payor Enrollment | Pivot Table | Provider enrollment
Education
N/A
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