Enrollment & Credentialing Representative

Tasks

• Collect and compile intake information
• Evaluate claim problems
• Follow up on physician enrollment status
• Identify data disparities in plan linkage
• Maintain physician credentialing files
• Process intake applications with primary source verification
• Resolve credentialing and claims payment issues
• Review files for delegated managed care committee meetings
• Update physician information in plan databases

Perks/Benefits

• N/A

Skills/Tech-stack

Data Analysis | Data Filtering | Data Reconciliation | Data sorting | Excel | Microsoft Access | Microsoft Word | Primary Source Verification | Project Management | Relational Database | Source verification