Provider Enrollment Specialist Job Description Template
Our company is looking for a Provider Enrollment Specialist to join our team.
Responsibilities:
- F Update the system and the credentialing database to reflect approvals, denials, and/or terminations;
- Outreach providers as a result of mail being returned undelivered to XYZ COMPANY;
- Assists call center agents, all internal departments, providers, and potential providers with resolving Provider Enrollment issues and inquiries;
- Meets quality controls and production standards of the Provider Relations Department;
- Enter and maintain all provider information into database;
- Perform ongoing research to correct data so that it does not create duplicate providers, locations, and participation statuses;
- Continuously searches for process improvements to achieve accuracy and efficiencies. (5%);
- Verify prospective and current providers’ license, NPI, and other required enrollment documentation;
- Performs other duties as assigned or required;
- Assist with other duties as assigned;
- Track contract applications status;
- Maintain provider information by reviewing, entering, and following up on missing information;
- Verify accurate banking and billing information;
- Ensure all files have a welcome, denial, or term letter as appropriate;
- Enter and maintain provider applications, revalidations, and updates into the system.
Requirements:
- Good organizational skills;
- Meet established production and quality goals/metrics;
- Communicate and work well in a team environment;
- Ability to learn new software programs quickly;
- Proficient in the use of Excel;
- Good basic math skills;
- Excellent customer service skills;
- Ability to adapt to constantly changing environment;
- Excellent written and verbal communication skills;
- Experience with general computer software (Word, Outlook required);
- Strong business acumen;
- Previous experience working with files or the collection and coordination of data (preferred);
- Ability to make independent decisions;
- Strong attention to detail;
- Ability to prioritize and organize multiple tasks.