Provider Enrollment Specialist

Responsibilities

• Prepares documents necessary to enroll physicians and non-physician providers with insurance carriers.
• Maintains deletions, additions, and changes to the Physician Enrollment file pertaining to all pertinent information including review of payer membership.
• Handles telephone communications and written correspondence with providers and fiscal intermediaries in an efficient and effective manner that facilitates the Provider Enrollment process.
• Maintains updated information per Insurance carrier requirements through contact with the carriers and by reviewing bulletins, and other materials sent to the providers.
• Works in a team effort on projects such as new start-ups, renewals, re-credentialing applications as required by Insurance carriers.
• Prepares documents in a consistent and accurate manner.
• Communicates information to input into Cactus and Epic system including new providers and updates of provider information using the appropriate forms.
• Responsible for working enrollment issues.
• Responsible for working provider enrollment claims in Epic.
• Follows department and Insurance payer guidelines for preparing documents in a consistent and accurate manner.
• Reports any detected problems, errors, and/or changes in provider enrollment requirements, when discovered.
• Understands and complies with department and organization policies and insurance carrier guidelines.

Qualifications

• Associate's degree in a related area of assignment, or equivalency.
• Three years of experience in professional support.