9 Mar 2020

Full-Time Provider Enrollment Specialist

RecruitDQ – Posted by RecruitDQ Milwaukee, Wisconsin, United States

Job Description

Primary responsibilities include receiving provider credentialing documents, pre-screening for completeness, scanning and re-routing. This permits accurate and timely processing of credentialing documents. This role also includes reviewing, scanning, filing and coordinating the execution of provider agreements. The intake review specialist enters provider data pertaining to applications, contract information, status changes, and payee changes.

• Electronically review assigned faxes and emails daily.
• Receive assigned mail relating to provider enrollment daily and turn electronic.
• Process assigned provider enrollment documents daily.
• Re-direct non-credentialing documents daily.
• Stamp all enrollment documents assigned daily.
• Conduct review of assigned provider enrollment documents daily.
• Research for active records in enterprise system.
• Enter or update existing provider records in enterprise system.
• Conduct review of assigned provider enrollment documents daily.
• Work with providers by phone, fax, U.S. mail, and email to ensure that they complete the enrollment process.
• Follow up with providers to ensure that all necessary information is received and that the enrollment process is completed timely.
• Develop relationships with providers and their staff and answer questions they may have about the process.
• Coordinate scanning of documents and store electronically to Cactus credentialing software.
• Track daily intake volumes.
• Audit provider contract effective dates for execution.
• Coordinate contract execution.
• Scan provider contracts.
• Electronically file provider contracts.
• Research and correct data to avoid duplicate provider, locations or payees.
• Other duties as needed or required.


• High School diploma or equivalent
• 2 years of experience in business environment.
• Proficient in the use of Excel.
• Proficient in general computer software (Word, Outlook, Powerpoint).
• Excellent customer service skills.
• Excellent verbal and written communication skills.
• Ability to learn new software programs quickly.
• Ability to create status reports on metrics.
• Ability to analyze data to determine next steps.
• Ability to prioritize and organize multiple tasks.
• Ability to remain organized amid multiple interruptions.
• Ability to work in a fast paced environment.
• Ability to make independent decisions.
• Attention to detail.
• Ability to adapt to constantly changing environment.
• Ability to work in excess of 40 hours.
• Required to attend additional training as requested/deemed necessary.

• Associate’s degree preferred.
• Experience in credentialing preferred.
• Proficiency in the use of Cactus credentialing software preferred.

• Incumbent must be able to communicate effectively.
• Requires overall light physical effort (up to 25lbs.)
• Manual dexterity and sitting is required in carrying out position own position responsibilities (i.e. use of personal computer).
• Ability to travel or move about within and outside serviced facilities required.
• Incumbent works primarily in either a private or shared office environment.

How to Apply

To be considered for this role, please apply here: http://gr.8job.co/GDrkCKBd

Job Categories: Equal Opportunities. Job Types: Full-Time.

Job expires in 64 days.

62 total views, 2 today

Apply for this Job