Hybrid Sr. Specialist, Payer Enrollment bei AEG Vision
AEG Vision · Alton, Vereinigte Staaten Von Amerika · Hybrid
- Professional
- Optionales Büro in Alton
The primary purpose of this position is to on-board new doctors relative to CAQH, Credential My Doc, and general credentialing and contracting in order to ensure prompt payment from insurance plans.
- Procure payer contracts for the purpose of billing and payment collections
- Will be the Subject Matter Expert on documentation, workflow, and process for managed care & commercial/medical payors contracting processes
- Prepares and submits enrollment applications, contract requests, and CHOWS along with supporting documentation to payors to ensure timely enrollment
- Maintains and checks status of all pending and completed contract applications with payors
- Support the team in processing documentation required to initiate and maintain proper medical credentialing for doctors, both IOA & external providers, organizing and obtaining all needed documents from insurance plans and doctors, and submits to the insurance board for processing
- Tracks credentialing in process utilizing Credential Stream and maintains credentialing files on each O.D
- Load and maintain O.D. files in Credential Stream
- Maintains and updates all doctor’s CAQH applications
- Maintains credentialing spreadsheets and communicates changes in status to billing, retail, and call center staff
- Assists in on-boarding new doctors to initiate smooth credentialing process
- Assists the doctors in filing for/renewing OD and drug licenses
- Assists the MVC Director in re-contracting new AEG Practices so they are participating within an AEG Vision TIN
- Maintains excellent working relationships with payors and carrier contracting teams to ensure timely and accurate credentialing status
- Assist the Managed Care Director in activities related to contracting medical and vision plans
- Performs clerical / administrative duties in support of the Credentialing Manager and Managed Care Director
- Makes recommendations for efficiencies, processes, etc. which will deliver either quality, cost savings, and / or profitability improvements within the department
- May be asked to provide assistance with Managed Care/Operations related projects not listed in this description