Network Enrollment Specialist

Job Description

This role is responsible for ensuring timely and accurate processing of payer enrollment applications for clinics and providers. The successful candidate will provide quality control for individual enrollment applications submitted for Medicare and Medicaid programs, resolve claims issues for individual payers in the corporate billing system, and maintain compliance with individual government payers through credentialing, re-credentialing, and audit processes.

The ideal candidate will have 2-5 years of work experience with government payers and 1 year of experience with provider enrollment. They will be adept at problem-solving and decision-making skills, able to work independently, and proficient in Excel and Outlook. Responsibilities:

• Ensure timely and accurate processing of payer enrollment applications.
• Provide quality control for individual enrollment applications submitted for Medicare and Medicaid programs.
• Maintain compliance with individual government payers through credentialing, re-credentialing, and audit processes.
• Resolve claims issues for individual payers in the corporate billing system.

Requirements:

• 2-5 years of work experience with government payers.
• 1 year of experience with provider enrollment.