Post Job

Benefit Specialist Vs Provider Enrollment Specialist

The differences between benefit specialists and provider enrollment specialists can be seen in a few details. Each job has different responsibilities and duties. It typically takes 4-6 years to become both a benefit specialist and a provider enrollment specialist. Additionally, a benefit specialist has an average salary of $48,756, which is higher than the $39,494 average annual salary of a provider enrollment specialist.

The top three skills for a benefit specialist include customer service, HR and patients. The most important skills for a provider enrollment specialist are data entry, patients, and CAQH.

Benefit specialist vs provider enrollment specialist overview

Benefit SpecialistProvider Enrollment Specialist
Yearly Salary$48,756$39,494
Hourly rate$23.44$18.99
Growth Rate7%7%
Number Of Jobs31,66342,271
Job Satisfaction--
Most Common DegreeBachelor's Degree, 59%Bachelor's Degree, 46%
Average Age4545
Years Of Experience66

What does a Benefit Specialist do?

A benefits specialist is responsible for analyzing and processing the compensation package of an organization, ensuring that the salary and benefits received by an employee adhere to the current legislation procedures. Benefits specialists develop benefits programs, adjusting pension plans and insurance options as needed, and updating the employees on recent updates and changes. A benefits specialist responds to employees' inquiries, addresses their concerns, and manages benefits issues. A benefits specialist must have a clear understanding of benefits policies and processes to educate employees about the benefits structure.

What does a provider enrollment specialist do?

A provider enrollment specialist is in charge of handling application procedures in a company or facility. Their responsibilities typically revolve around gathering information, reviewing and verifying requirements, processing applications, and liaising with clients. They may also maintain and update databases, assist during complicated procedures, and ensure that all requirements are complete and accurate. Furthermore, as a provider enrollment specialist, it is essential to discuss terms and conditions to clients, helping them understand the company's policies and regulations, including its vision and mission.

Benefit specialist vs provider enrollment specialist salary

Benefit specialists and provider enrollment specialists have different pay scales, as shown below.

Benefit SpecialistProvider Enrollment Specialist
Average Salary$48,756$39,494
Salary RangeBetween $34,000 And $68,000Between $28,000 And $54,000
Highest Paying CitySan Francisco, CAOakland, CA
Highest Paying StateConnecticutAlaska
Best Paying CompanyQorvoMcKinsey & Company Inc
Best Paying IndustryFinanceTechnology

Differences between benefit specialist and provider enrollment specialist education

There are a few differences between a benefit specialist and a provider enrollment specialist in terms of educational background:

Benefit SpecialistProvider Enrollment Specialist
Most Common DegreeBachelor's Degree, 59%Bachelor's Degree, 46%
Most Common MajorBusinessBusiness
Most Common CollegeUniversity of PennsylvaniaUniversity of Pennsylvania

Benefit specialist vs provider enrollment specialist demographics

Here are the differences between benefit specialists' and provider enrollment specialists' demographics:

Benefit SpecialistProvider Enrollment Specialist
Average Age4545
Gender RatioMale, 21.1% Female, 78.9%Male, 19.6% Female, 80.4%
Race RatioBlack or African American, 11.0% Unknown, 3.6% Hispanic or Latino, 15.3% Asian, 7.5% White, 62.2% American Indian and Alaska Native, 0.3%Black or African American, 12.5% Unknown, 3.6% Hispanic or Latino, 15.6% Asian, 7.5% White, 60.4% American Indian and Alaska Native, 0.3%
LGBT Percentage9%9%

Differences between benefit specialist and provider enrollment specialist duties and responsibilities

Benefit Specialist Example Responsibilities.

  • Manage various employee program such as life, medical, dental pension, and HSA accounts.
  • Examine HMO documents to verify eligibility to process or reject into or from a manage care plan when necessary.
  • Input daily time and PTO, manage benefits, report new hires, input sales, oversee accounts receivable.
  • Create reports using SQL database and manage reports, perform from internet-base tools for research projects need for client insight.
  • Implement new vendor for FSA administration and manage outstanding issues through continuous follow-up and vendor accountability.
  • Analyze, process and manage FMLA claims to determine eligibility and certification in compliance with state and federal regulations.
  • Show More

Provider Enrollment Specialist Example Responsibilities.

  • Manage federal and state-mandate physician credentialing activities; act as NCQA committee liaison.
  • Provide enrollment counseling to eligible recipients about Medicaid manage care and promote their voluntary enrollment into an HMO.
  • Review provider enrollment applications to ensure the credentials and licenses meet all requirements for participation in the Medicare program.
  • Verify provider is eligible to participate in Medicare according to CMS guidelines.
  • Verify claim information using ICD-9 and medical terminology and CHAMPUS/ TRICARE guidelines .!
  • Complete require forms and application for changes or updates in billing systems including EFT and or notification of Athena.
  • Show More

Benefit specialist vs provider enrollment specialist skills

Common Benefit Specialist Skills
  • Customer Service, 13%
  • HR, 8%
  • Patients, 5%
  • HRIS, 5%
  • Life Insurance, 5%
  • Cobra, 5%
Common Provider Enrollment Specialist Skills
  • Data Entry, 12%
  • Patients, 12%
  • CAQH, 9%
  • Medicare, 7%
  • Medicaid, 7%
  • Provider Enrollment Applications, 6%

Browse business and financial jobs