Description
Coordinates employed and contracted billable provider's and facilities initial enrollment and re-credentialing process with third party payers, out of state Medicaid and Medicare. Includes NPI management for facilities. Maintains database for hospital, group and billing providers and provides reports as requested. Research claim denials related to provider enrollment/credentialing issues. Build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Assist with the full range of provider relations and service interactions, including working on end-to-end provider claim and call quality and training and development of external provider education programs. Bachelor?s degree and experience. Under FLSA, incumbents in this position are nonexempt.