Responsibilities:
The Provider Enrollment Specialist:
• Interact professionally with providers and ancillary staff to provide appropriate and timely responses to inquiries and concerns regarding provider enrollment and file maintenance for Medicaid programs (including dental, vision, ambulance, physicians, nurses, and all other provider types);
• Process to completion 100% of assigned applications and maintenance requests utilizing documented work instructions, daily and meeting minimum daily quotas.
• Identify deficiencies to notify providers of incomplete/inaccurate applications; revising existing deficiencies and sending corrections based on QA audits as required.
• Respond to inquiries regarding the status of applications received.
• Research and contact providers via phone to resolve enrollment application deficiencies.
• Adhere to the Quality Assurance program in order to improve the daily processing of applications and file maintenance transactions with a minimum quality score of 98%.
• Makes recommendations to management to improve efficiency/effectiveness of current processes
• Maintain strict confidentiality of information and job files as dictated by current HIPAA requirements.
• Flexibility to work overtime as dictated by daily production inventory requirements.
• Perform other duties as assigned by leadership.

Basic Qualifications:
• Minimum of 6 months of experience enrolling and credentialing healthcare providers

Skills:
• Strong computer skills.
• Ability to meet strict deadlines.
• Great attention to detail.
• Excellent communication skills.
• Outstanding problem-solving and organizational abilities.
• Ability to multitask and manage time effectively.
• Flexibility and adaptability in a growing work environment.