Key Responsibilities:Payer Enrollment Management:Oversee the enrollment and revalidation process for healthcare providers with various payers.Prepare, submit, and track enrollment applications to ensure timely approval.Verify the accuracy of provider information, including NPI, tax ID, licenses, and certifications.Compliance and Documentation:Ensure compliance with federal, state, and payer-specific regulations.Maintain up-to-date knowledge of payer
Key Responsibilities:Payer Enrollment Management:Oversee the enrollment and revalidation process for healthcare providers with various payers.Prepare, submit, and track enrollment applications to ensure timely approval.Verify the accuracy of provider information, including NPI, tax ID, licenses, and certifications.Compliance and Documentation:Ensure compliance with federal, state, and payer-specific regulations.Maintain up-to-date knowledge of payer
. 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
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