About This Role
This role is for a Provider Enrollment Account Manager who will be the main point of contact for clients, overseeing the provider enrollment process from start to finish. The Account Manager is responsible for monitoring progress, managing client communication, coordinating resources, and resolving issues to ensure timely and accurate enrollment activities.
Responsibilities
- Serve as the primary point of contact for assigned clients and manage the day-to-day client relationship
- Manage and participate in provider enrollment, recredentialing, and contracting activities
- Coordinate and assign enrollment-related work to the offshore team and provide direction and support as needed
- Monitor assigned work to ensure enrollment activities are completed accurately and within expected timeframes
- Maintain knowledge of payer enrollment requirements and provide guidance to the offshore team regarding payer requirements and follow-up
- Coordinate with clients to obtain information, documentation, and signatures required for enrollment and contracting activities
- Assist in coordinating payer follow-up on submitted applications, network participation requests, and outstanding enrollment matters
- Provide clients with regular status updates regarding enrollment activity, outstanding items, and application progress
- Communicate with clients, providers, payers, the offshore team, and internal departments as necessary to resolve enrollment-related issues
- Maintain required client and enrollment documentation within applicable company systems
- Identify enrollment issues or delays and work with the appropriate parties to facilitate resolution
- Provide feedback and recommendations to improve processes, reduce errors, and improve the overall client experience
- Maintain confidentiality of provider credentials and client information
- Perform database and computer functions as required in accordance with company policies
Requirements
- 5+ years of provider/payer enrollment experience with Federal and commercial payers
- Strong knowledge of provider enrollment, re-enrollment, credentialing, and payer processes
- Excellent communication, organizational, client service, and problem-solving skills
- Ability to independently manage multiple client accounts, priorities, and enrollment workflows
- Ability to exercise sound judgment, resolve routine issues, and escalate appropriately when necessary
- Strong computer and software skills (PECOS, Availity, UHC Onboard Pro, etc.)
Nice to have:
- Experience working with or directing offshore teams
Important Details