This position is responsible for the overall administration of the provider enrollment process for new and existing clients as well as assuring new client start-ups are being effectively managed.
Essential Duties and Responsibilities:
- Preparing and submitting enrollment applications
- Following up on the status of applications for clients
- Keep detailed log of all pending and completed work
- Maintain/Update credentialing reports
- Manage new client start-up, group enrollment, and special projects
- Communicate enrollment status to those involved on an as needed basis
- Resolve issues related to provider or NPI numbers
- Deactivation of provider numbers, effective dates, NPI related denials, NPI website, etc.
- Manage state and client master applications
Foundation Knowledge, Skills, and/or Abilities Required:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Educational/Vocational/Previous Experience Recommendations:
- High school diploma or equivalent required
- 3 – 5 years experience working in credentialing and/or enrollment preferred
- Knowledge of provider enrollment process and requirements for commercial insurance companies, CMS Federal and State Guidelines related to enrollment policies preferred
- Ability to effectively communicate both in writing and verbally, as well as to interact in a professional manner with colleagues, patients, public, and client’s staff members required
- Proficient with MS Office products preferred
- Ability to multi-task needed