Senior Provider Enrollment Representative

Job Summary

A company is looking for a Senior Provider Enrollment Representative who will assist in managing provider credentialing processes.

Key Responsibilities

• Process provider applications and maintain database tracking systems
• Conduct audits and provide feedback to enhance processes and reduce errors
• Act as a technical resource and facilitate conflict resolution within the team

Required Qualifications

• High School Diploma/GED or 5+ years of provider credentialing experience
• 4+ years of health care provider enrollment/credentialing experience
• 2+ years of experience with compliance workflows and NCQA policies
• 2+ years of experience with Medicare and state Medicaid programs in specific states
• Intermediate proficiency with MS Excel and Word, and computer systems