Provider Enrollment Specialist
Tasks
- Act as liaison with payers hospitals and credentialing verification organizations
- Apply for license renewals
- Communicate credentialing updates to providers
- Complete provider enrollment applications
- Follow SOPs and compliance policies
- Follow up with health plans and hospitals
- Maintain data quality
- Maintain provider data in MD Staff
- Meet state federal and payer credentialing requirements
- Monitor application timelines
- Process credentialing re-credentialing and privileging applications
- Resolve credentialing issues with IPAs and health plans
Perks/Benefits
Skills/Tech-stack
Compliance Management | Credentialing | Critical Thinking | Data Quality | Database Management | Medicaid | Medicare | Microsoft Office | NCQA | Payer requirements | Privileging | Problem Solving | Provider enrollment | Re-credentialing | SOPs | Verbal communication | Written communication
Education
Bachelor of Arts | Bachelor of Engineering | Bachelor of Science
Roles
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