Medicaid Provider Enrollment Compliance Specialist

2 weeks ago

Springfield, Illinois, United States Cogent Infotech Corp Full time
**Remote - Fulltime - Competitive Salary - Full Benefits
This role is essential in managing the enrollment applications and updates for Medicaid Health Care Providers within the State's approval framework. The key responsibilities of this position include verifying provider credentials through various governmental agencies and licensing boards, as well as ensuring the accuracy of provider demographic and billing data within the State's system.
Responsibilities include:
  • Conducting thorough research, verification, and documentation of provider credentialing information in accordance with enrollment regulations.
  • Maintaining detailed communication logs and documenting resolution outcomes.
  • Reviewing the entirety of applications and update submissions to confirm the accuracy of all data and the completeness of revalidation documents.
  • Collaborating daily with State Management Staff to ensure timely submission and approval of Medicaid provider applications.
Requirements:
  • A minimum of 3 years in a similar role with a comprehensive understanding of Medicaid and provider enrollment processes.
  • In-depth knowledge of Medicaid provider credentialing standards and requirements.
  • Experience assisting Medicaid Providers with state processes, policies, and procedures.
  • Proven track record of accomplishments with effective documentation of communication and outcomes.
  • Exceptional organizational, communication, and interpersonal skills.
  • Strong customer service experience, ideally in a provider services call center or credentialing department.
  • Excellent oral and written communication skills, with the ability to engage in webinars and seminars and interact effectively with leadership.
  • Ability to thrive in a fast-paced, deadline-driven environment.
  • Proficiency in Microsoft Office Suite (PowerPoint, Word, Excel, and Outlook).
  • Capability to work collaboratively as part of a team as well as independently.
  • Ability to manage multiple complex tasks simultaneously.
  • Experience in a healthcare setting with an understanding of provider billing practices and claims processing is preferred.
  • Physical requirements include the ability to remain in a stationary position for extended periods.
Education:
A Bachelor's degree in Business Administration, Public Administration, or equivalent work experience equivalent to four (4) years of college.

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