1. End-to-End Enrollment Management
2. Compliance & Regulatory Adherence3. Issue Resolution & Escalations
● Investigate and resolve complex enrollment issues—rejections, NPI/taxonomy
discrepancies, 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 address
blockers.4. Process Improvement
● Identify inefficiencies in the enrollment workflow and recommend enhancements to
reduce turnaround time and improve accuracy.
● Support automation and system-improvement initiatives.
● Contribute to building standardized templates and best practices.5. Mentorship & Team Support
● Guide and mentor junior Analysts to improve their technical and process knowledge.
● Provide feedback through reviews, quality checks, and coaching discussions.
● Participate in team huddles, calibrations, and performance alignment meetings.6. Documentation & Reporting
● Maintain accurate records within CRM, internal workflow tools, payer portals, and
tracking sheets.
● Generate periodic reports on submissions, status updates, pending items, and
escalations.
● Ensure documentation meets audit and compliance expectations.Required Qualifications
● Minimum 2+ years of hands-on experience in Payer Enrollment—Commercial or
Medicaid, depending on the requirement.
experience
5show more
1. End-to-End Enrollment Management
2. Compliance & Regulatory Adherence3. Issue Resolution & Escalations
● Investigate and resolve complex enrollment issues—rejections, NPI/taxonomy
discrepancies, 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 address
blockers.4. Process Improvement
● Identify inefficiencies in the enrollment workflow and recommend enhancements to
reduce turnaround time and improve accuracy.
● Support automation and system-improvement initiatives.
● Contribute to building standardized templates and best practices.5. Mentorship & Team Support
● Guide and mentor junior Analysts to improve their technical and process knowledge.
● Provide feedback through reviews, quality checks, and coaching discussions.
● Participate in team huddles, calibrations, and performance alignment meetings.6. Documentation & Reporting
● Maintain accurate records within CRM, internal workflow tools, payer portals, and
tracking sheets.
● Generate periodic reports on submissions, status updates, pending items, and
...
escalations.
● Ensure documentation meets audit and compliance expectations.Required Qualifications
● Minimum 2+ years of hands-on experience in Payer Enrollment—Commercial or
Medicaid, depending on the requirement.
experience
5show more