Job Description

  • Independently manage the complete Medicare enrollment process via PECOS, including the preparation and submission of CMS-855I, 855B, 855R, and DME applications.
  • Manage the full NPI (Type 1 and Type 2) lifecycle through NPPES, including new registrations and updates.
  • Directly submit and track state‑specific Medicaid enrollment applications through state portals without departmental handoffs.
  • Maintain and navigate the Identity & Access (I&A) Management System to manage authorized official roles.

2. CAQH & Commercial Payer Management

  • Take 100% ownership of CAQH ProView profiles: initial setup, quarterly re-attestations, and ensuring all documentation (COI, licenses, board certs) is current.
  • Execute full-cycle commercial credentialing through Availity and individual payer portals (Anthem, BCBS, Aetna, Cigna, UnitedHealthcare, etc.).
  • Manage enrollment for specialized payers including Tricare, VA, and Managed...

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