Provider Enrollment Specialist
Sanford Health - Sioux Falls, SD

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Responsible for obtaining provider profile information; this includes verifying provider demographic, billing, credentialing, etc. information from providers in a timely manner. Entering provider enrollment and disenrollment data and maintaining the provider access database. Coordinate with the central verification office and management to resolve operational issues or provider profile discrepancies. Responsible for sending W-9 forms, 1099 letters, provider termination notification letters and other duties as assigned by the Manager.

Knowledge of credentialing requirements is useful. Skill in using office machines-fax, typewriter, computer and copier. Ability to examine documents for accuracy and completeness. Ability to establish priorities and coordinate work activities. Ability to maintain confidentiality of sensitive information. Ability to communicate clearly and concisely. Ability to work effectively with central verification office, provider office staff and internal health plan staff.

When students are providing patient care, treatment, and/or services as a part of their training, any/all employees may be asked to supervise the students.

Required Skills

High School graduation or GED required; Associate degree or graduate of an accredited Medical Assistant Program is preferred. Previous experience in health care field organization preferred. Prior insurance billing or credentialing experience is preferred.

Required Experience

About this company
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Sanford Health-MeritCare was created from the 2009 merger of two Dakota health care legends: South Dakota's Sanford Health and North...