Managed Care Specialist Job at Paragon Healthcare, Inc.
Role and Responsibilities
- Independently manage workflow, set priorities with internal stakeholders, and deliver results
- Front line contact for internal customers; respond to any re-credentialing related inquiries or issues
- Maintains pharmacy, infusion center, and Nurse Practitioner re-credentialing for payers, communicating timely, and accurate results to internal stakeholders, tracking progress on all pending applications
- Maintenance of payer enrollment and payer re-credentialing
- Responsible for the administrative maintenance of the payer re-credentialing files in SharePoint
- Liaison to patient access and revenue cycle management to resolve payment issues and reduce claim denials
- Process and facilitate CAQH Nurse Practitioner administrative profiles
- Responsible for maintaining the accuracy of NP credentialing and plan participation in payor databases and SharePoint
- Performs other duties as assigned
IND123M
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