Provider Enrollment Specialist

• Enter, update, and maintain provider information in internal systems
• Validate provider credentialing data, contracts, and demographic data
• Ensure provider records comply with CMS, HIPAA, and state/federal regulations
• Conduct routine audits and reconciliations to maintain data integrity
• Review and load required data into the health plan system according to process guidelines
• Manage and monitor daily activities and meet set targets
• Work independently and complete tasks within established timeframes with minimal supervision
• Prioritize and complete all job duties
• Adhere to changes based on department and/or business requirements

Provider Data Management Specialist – Enrollment

• Enter, update, and maintain provider information in internal health plan systems
• Validate provider credentialing data, contracts, and demographic information
• Ensure provider records comply with CMS, HIPAA, and state/federal regulations
• Conduct routine audits and reconciliations to maintain data integrity
• Review and load required data into the health plan system according to process guidelines
• Manage and monitor daily activities and meet set targets
• Work independently and complete tasks within established timeframes with minimal supervision
• Prioritize and complete all job duties
• Adhere to changes based on department and/or business requirements