JOB TITLE : Provider Enrollment Specialist / Credentialing
SUPERVISION RECEIVED : Reports to Provider Enrollment Manager. LOCATION : Metairie, 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.
Provider Enrollment Specialist
Provider Enrollment Specialist/Credentialing. Reports to Provider Enrollment Manager. Knowledge of Governmental and Private Provider enrollment processes and applications for Louisiana and other States. Responsible for all aspects of the credentialing, re-credentialing, and contracting processes for...
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