Provider Enrollment Specialist
Tasks
- Apply for license renewals
- Communicate credentialing updates to providers
- Complete provider enrollment applications
- Coordinate with payers hospitals and credentialing verification organizations
- Ensure state and federal payer credentialing compliance
- Follow SOPs and compliance policies
- Follow up with health plans and hospitals
- Maintain data quality for provider and credentialing records
- Maintain provider data in MD Staff
- Monitor application timelines
- Process credentialing and re-credentialing applications
- Process privileging applications
- Resolve credentialing issues with IPAs and health plans
- Resolve enrollment issues with health plans
Perks/Benefits
Skills/Tech-stack
Credentialing | Credentialing software | Database Management | MD Staff | Medicaid | Medicare | NCQA standards | Privileging | Provider enrollment | Re-credentialing
Education
Roles
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