Provider enrollment specialist vs retirement plan specialist

Differences between provider enrollment specialist and retirement plan specialist 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.
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Retirement plan specialist example responsibilities.

• Generate sales leads for personal investments, annuities and plan sales.
• Participate in establishing and testing pension plans on PeopleSoft to automate applicable calculations.
• Call into the ADP payroll client base to cross-sell retirement products and work with payroll reps on joint sales.
• Research and advise clients and attorneys on laws and regulations to comply with QDRO and federal guidelines.
• Train staff on ASC software and provide office support, as needed, for issues and new training.
• Assist in the planning, testing and conversion of the company's payroll system from GEAC to JD Edwards.
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