Enrollment Specialist, Medical Board
Tasks
- Analyze and update billing reports
- Conduct pre audits of credentials files
- Liaison with medical group leadership
- Maintain National Provider Identifier records
- Manage EMDNY accounts
- Manage PECOS accounts
- Manage delegated credentialing
- Oversee managed care enrollment
- Reconcile billing denials with vendors
- Reconcile monthly health plan provider rosters
- Serve as authorized official for Medicare and Medicaid
- Track provider demographics and CAQH IDs
- Update payor participation status
- Update provider panels and reassignment files
Perks/Benefits
- N/A
Skills/Tech-stack
Billing Denials Reconciliation | CAQH | Cactus | Credential Pre Audit | Delegated Credentialing | EMDNY | Managed Care Enrollment | Managed care | Medicaid | Medicare | NCQA standards | National Provider Identifier | PECOS | Panel management | Provider Panel Management | Provider enrollment | Symplr Cactus
Education
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