POSITION SUMMARY:
Responsible for preparing and submitting credentialing applications and supporting documentation for the purpose of enrolling individual physicians and physician groups with payers.
ESSENTIAL FUNCTIONS:
Manage the completion and submission of provider enrollment applications
Maintain documentation and reporting regarding provider enrollments in process
Retain records related to completed provider enrollments.
Maintain provider enrollment information within the credentialing database
Interact professionally with providers, ancillary staff and plan representatives to provide appropriate and timely response to inquiries and concerns regarding provider
Respond to inquiries regarding status of applications received
Follow up with insurance plans to monitor status of provider applications
Research and contact providers to resolve enrollment application deficiencies
Send out provider applications, forms and other provider correspondence as requested
Maintain strict confidentiality of information as dictated by current HIPAA requirements
OTHER WORK RELATED FUNCTIONS:
Team with peers for effective and efficient work flow
Obtain and/or enter information in a timely and efficient manner
Participate in departmental meetings
Other duties as assigned
POSITION QUALIFICATION & SKILLS:
Educational Equivalent: High School Diploma, AA preferred
Skills:
Problem solving skills for the identification of issues and the ability to develop appropriate courses of action
Proficient computer skills
General office skills
Excellent verbal and written communication skills
Excellent organizational skills for prioritizing tasks to meet set deadlines
Excellent cognitive and judgment skills