Operations

• Prepare and maintain provider enrollment applications (CAQH, PECOS, Medicaid portals, commercial payers).
• Track credentialing and re-credentialing timelines, ensuring timely renewals.
• Maintain accurate provider files and credentialing databases.
• Support contracting submissions and documentation for Medicare Advantage and commercial payers.
• Track contract status, effective dates, and reimbursement schedules.
• Coordinate with Practice Manager on payer inquiries and escalations.
• Verify patient eligibility and benefits prior to appointments and assist with documentation of member responsibility and coverage rules.
• Troubleshoot eligibility issues with payers and escalate as needed.
• Maintain trackers, dashboards, and reports for credentialing, contracting, and eligibility.
• Support compliance and quality programs and assist with general administrative functions of practice management as assigned.

Practice Operations Coordinator

Senior Healthcare Analyst – ACO, Primary Care Operations

Vice President, Commercial Operations

Operations Manager

Operations Specialist

Manager, Operations Implementation, Health Plan