C&E Account Representative
• Manage Assigned Client Accounts – Serve as the primary point of contact and coordinate credentialing and enrollment activities across each client’s assigned providers, locations, and payers.
• Manage Commercial and Medicaid Enrollment – Complete enrollment, revalidation, demographic updates, location additions, terminations, and other maintenance activities for assigned commercial, managed care, and state Medicaid payers.
• Maintain State Medicaid Portals When Assigned – Manage client and provider information within assigned state Medicaid portals, monitor revalidation and maintenance requirements, respond to requests for additional information, and protect portal access and sensitive data.
• Coordinate Medicare Responsibilities – Collaborate with the Medicaid and Medicare Account Representative when Medicare enrollment is assigned to that role, maintaining clear ownership and sharing required provider and organizational information.
• Monitor Applications and Follow-Up – Track submissions, payer communications, effective dates, outstanding documentation, and follow-up activity through completion, escalating barriers that could affect participation or reimbursement.
• Maintain Accurate Records and Reporting – Keep MDStaff, reference spreadsheets, client reports, payer portals, and supporting documentation complete, current, and consistent.
• Communicate With Clients and Internal Teams – Provide timely status updates, clearly identify outstanding needs, and coordinate next steps with clients, account leads, and specialized enrollment staff.