Provider enrollment specialist vs benefits & payroll administrator

Differences between provider enrollment specialist and benefits & payroll administrator duties and responsibilities

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

Benefits & payroll administrator example responsibilities.

• Manage HRIS, recruiting, training, and time and attendance programs as well as trouble shooting.
• Create reports using SQL database and manage reports, perform from internet-base tools for research projects need for client insight.
• Ensure accuracy of all benefit enrollments and life status changes record in the HRIS to provide vendors with accurate eligibility information.
• Complete weekly internal payroll reports and fund employee accounts (HSA and 401K).
• Process benefit elections, merit raises, salary changes, garnishments, cobra and severance.
• Administer employee benefits programs including group medical, dental, vision, group life and FSA.
Show more