Compensation coordinator vs provider enrollment specialist

Differences between compensation coordinator and provider enrollment specialist duties and responsibilities

Compensation coordinator example responsibilities.

• Manage e-verify process for the entire organization working closely with remote managers to ensure timely access to documents.
• Administer company FMLA leave policies and procedures while reviewing claims for safety hazards and attend hearings as required.
• Design documents to provide FMLA clarification/responsibilities to employees and management.
• Process and coordinate appeal requests from members and providers while exceeding contractual and NCQA regulatory requirements for commercial and Medicaid members.
• Create presentations for weekly department meeting using PowerPoint software.
• Develop and administer internal databases in a SQL environment consistent with the departmental objectives.

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.
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