Provider Enrollment Specialist
4 weeks ago
JOB TITLE: Provider Enrollment Specialist/Credentialing
SUPERVISION RECEIVED: Reports to Provider Enrollment Manager.
LOCATION: Lafayette, LA
GENERAL SUMMARY OF DUTIES: Responsible for all aspects of the credentialing, re-credentialing, and contracting processes for medical providers in private practice or group settings.
ESSENTIAL FUNCTIONS:
* Prepare and submit Governmental and Private Carrier applications for initial submission and re-credentialing and follow-up as needed.
* Acquire and process new Managed Care Agreements.
* Maintain detailed log of all pending and completed work.
* Apply and update NPI Numbers through the NPI Website.
* Apply and maintain EDI, EFT & ERA processes.
* Maintains strictest confidentiality.
* Follows established policies and procedures listed in the Employee Handbook, ACS Practice Management, Compliance and HIPPA Manuals.
* The job holder must demonstrate competencies applicable to the job position while performing duties in a professional and courteous manner.
EDUCATION:
* High school diploma or GED.
SKILLS & KNOWLEDGE:
* Knowledge and understanding of the credentialing/enrollment process.
* Knowledge of Governmental and Private Provider enrollment processes and applications for Louisiana and other States.
* Knowledge of CMS Federal and State Guidelines.
* Knowledge of Prime Source Verification.
* Knowledge of CAQH.
* Proficient use of Microsoft Office Word, Excel, and Outlook.
* Knowledge of grammar, spelling and punctuation to type correspondence.
ABILITIES:
* Ability to read, understand and follow oral and written instruction.
* Ability to sort and file materials correctly by alphabetic or numeric systems.
* Ability to organize and prioritize work and manage multiple priorities.
* Ability to communicate clearly and concisely.
* Ability to establish and maintain effective working relationships with patients, employees and the public.
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