The Provider Enrollment Subject Matter Expert (SME) must Interact professionally with providers and ancillary staff to provide appropriate and timely response to inquiries, escalations or concerns regarding provider enrollment and file maintenance for client programs.
Key Responsibilities:
Monitor the daily operations of enrollment activities to ensure daily inventory requirements are met per contractual obligations
Act as subject matter expert and escalation point to resolve issues and continuously look to improve accuracy and the employee experience
Monitor and review internal and external quality assurance results to improve daily processing of applications and file maintenance transactions
Participate and contribute to the development of strategic long and/or short-range goals
Make recommendations to management to improve
efficiency/effectiveness
of current manual processes
Maintain strict confidentiality of information and job files as dictated by current HIPAA requirements
Maintain flexibility to work overtime as dictated by daily production inventory requirements
Perform other duties as assigned by leadership