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Provider Enrollment and Credentialing Specialist
1 month ago
This position assists with all aspects of client services, including client service and customer support duties.
Responsibilities include:
Ensure all service level agreement specifications are met within the customer's timeline. Responsible for communications to clients related to company services and agreements.
Complete Enrollment projects & communicate progress via internal and external status reports & client communications.
Perform negotiations for client service contracts and insurance payer fee schedules for providers and free-standing centers.
Manage and execute client service requests.
Maintain client relationships & ensure clients' needs are met within the scope of the business agreement.
Advise management on issues arising from product or service problems reported by customers & vendors.
Assists with client onboarding, estimated budgets, and performance presentations.
Investigate client needs and expedite solutions such as custom training.
Maintain client documentation & correspondence such as Service Agreements, Provider credentials, Insurance contracts and renewals, & business proposals.
Conduct surveys, obtain client feedback and recommend service improvements.
Assist team members to meet client needs and process insurance appeals.
Address client inquiries and issues in a timely and accurate manner.
Develop and deliver client presentations and reports as needed.
Manage daily calls and projects.
Maintain physician fee schedules in accordance with established coding practices and governmental regulatory requirements. Configure and maintain fee schedules in practice management software. Request and analyze fees schedules annually by payer per provider. Assist with payer fee schedule negotiations and corrections. Analysis of payer performance based on payments versus contracted fee schedule.
Complete, maintain, and process pertinent paperwork and records.
Special projects as assigned
Requirements: Education / Experience: Bachelor's degree from four-year college or university and over 5 years managing client service relationships. Working knowledge of Microsoft Office Suite, Radiation Oncology, Centricity software experience a plus, 5 years Provider Enrollment or Medical Office Experience preferred.
Certificate / License Preferred: CPC, CCS-P or ROCC.
