1. End-to-End Enrollment Management2. Compliance & Regulatory Adherence3. Issue Resolution & Escalations● Investigate and resolve complex enrollment issues—rejections, NPI/taxonomydiscrepancies, retro-effective enrollment, and portal conflicts.● Serve as a point of escalation for difficult payer inquiries.● Coordinate with internal Quality, Credentialing, and Provider Data teams to addressblockers.4. Process Improvement● Identify inefficiencies in the enro
1. End-to-End Enrollment Management2. Compliance & Regulatory Adherence3. Issue Resolution & Escalations● Investigate and resolve complex enrollment issues—rejections, NPI/taxonomydiscrepancies, retro-effective enrollment, and portal conflicts.● Serve as a point of escalation for difficult payer inquiries.● Coordinate with internal Quality, Credentialing, and Provider Data teams to addressblockers.4. Process Improvement● Identify inefficiencies in the enro
The primary goal of this position is to manage the complex administrative and compliance-driven processes required for healthcare professionals to practice and for the organization to receive payment.Provider Credentialing (Verification and Compliance)Credentialing is the process of verifying a healthcare provider's qualifications to ensure they meet professional and regulatory standards. It's the quality control step.experience5
The primary goal of this position is to manage the complex administrative and compliance-driven processes required for healthcare professionals to practice and for the organization to receive payment.Provider Credentialing (Verification and Compliance)Credentialing is the process of verifying a healthcare provider's qualifications to ensure they meet professional and regulatory standards. It's the quality control step.experience5