Provider Enrollment Specialist bei AEG Vision

The primary purpose of this position is to assist the Credentialing Lead and Sr. Director, MVC/RCM perform the duties required to credential all doctors for all medical and vision plans.

• 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 My Doc and maintains credentialing files on each O.D. and M.D.
• Loads all new Doctors information into Credential My Doc, as well as maintains all Doctors files in Credential My Doc
• 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
• 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 Lead and Sr. Director, MVC/RCM
• Makes recommendations for efficiencies, processes, etc. which will deliver either quality, cost savings, and / or profitability improvements within the department