Provider Enrollment Specialist

Full Time
Remote
Posted 30+ days ago
Job description
Overview:

Job Summary:

  • The Provider Enrollment Specialist works in conjunction with the Provider Enrollment Manager to identify Provider Payer Enrollment issues or denials. This position is responsible for researching, resolving, and enrolling any payer issues, utilizing a variety of proprietary and external tools. This may require contacting clients, operations personnel, and Centers for Medicare & Medicaid Services (CMS) via phone, email, or website.
Responsibilities:

Essential Functions and Tasks:

  • Performs follow-up with market locations to research and resolve payer enrollment issues.
  • Performs follow-up with Centers for Medicare & Medicaid Services (CMS), and other payer via phone, email or website to resolve any Payer Enrollment issues.
  • Manages the completion and submission of CMS Medicare, State Medicaid and any other third-party payer applications.
  • Performs tracking and follow-up to ensure provider numbers are established and linked to the appropriate client group entity and proper software systems.
  • Maintains documentation and reporting regarding payer enrollments in process.
  • Retains records related to completed CMS applications.
  • Establishes close working relationships with Clients, Operations, and Revenue Cycle Management team.
  • Performs special projects and other duties as assigned.
Qualifications:

Education and Experience Requirements:

  • High School Diploma or Equivalent. Bachelor’s Degree in Healthcare Administration, Business Administration, Benefits, or equivalent training and/or experience preferred.
  • Four (4) years of provider enrollment experience.

Knowledge, Skills, and Abilities (KSAs):

  • Working knowledge of specific application requirements for Centers for Medicare & Medicaid Services (CMS), State Medicaid and all third-party payers including pre-requisites, forms required, form completion requirements, supporting documentation such as Drug Enforcement Agency Number (DEA), Curriculum Vitae (CV), and regulations.
  • Working knowledge of physician HIPAA Privacy & Security policies and procedures.
  • Strong oral, written, and interpersonal communication skills.
  • Strong word processing, spreadsheet, database, and presentation software skills.
  • Strong detail orientation skills.
  • Strong analytical skills.
  • Strong decision-making skills.
  • Strong problem-solving skills.
  • Strong organizational skills.
  • Strong time management skills.
  • Strong mathematical skills in addition, subtraction, multiplication and division of whole numbers and fractions; and working with decimals.
  • Ability to ensure the complex enrollment packages are complete and correct.
  • Ability to work cohesively in a team-oriented environment.
  • Ability to foster good working relationships with others both within and outside the organization.
  • Ability to work independently and require little supervision, to focus on and accomplish tasks.
  • Ability to maintain strict confidentiality with regards to protected provider and health information.
  • Ability to take initiative and effectively troubleshoot while focusing on innovative solutions.
  • Ability to exercise sound judgment and handle highly sensitive and confidential information appropriately.
  • Ability to remain flexible and work within a collaborative and fast paced environment.
  • Ability to communicate with diverse personalities in a tactful, mature, and professional manner.

IND1

Intrested in this job?

Related Jobs

All Related Listed jobs

Local Kitchens Granite Bay, CA 3 days ago

Highest quality standard in the room - Protect food quality by being detail oriented and following kitchen procedures. Own inventory ordering / manage waste.

Bright Health Diamond Bar, CA Today

Back to Career Site Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the

Job Description What is this job about? You will be a therapist on a remote Telehealth Platform. Client sessions are usually 45 minutes long and can be

Work Now Staffing Tampa, FL 33609 Today

Work Now Staffing is looking to hire Security Guards (Unarmed) for our Bradeton, FL client. Pay: $12.00 Shift: Monday - Friday- 9:00am - 9:00pm Job Details: Monitoring activities on

Healthy Kids Programs Newburgh, NY 12550 $14 - $15 an hour 6 days ago

Provide a safe, healthy, and fun environment and act as a positive role model for children in the program. JOB STATUS: Nonexempt; part time.

The Patient Scheduling Specialist at Alleviant Health Centers will speak directly with patients or outside referrals sources to assist with scheduling patients for intake or rescheduling their next

Accura HealthCare of Le Mars Le Mars, IA 51031 Today

Accura HealthCare of Le Mars is a 46 bed SNF. We are always looking for great nurses, regardless of FT, PT and PRN potential, to join our team. We offer a collaborative, family oriented, team

Vita Tech Inc Forest, VA 24551 Today

Eager to learn to new skills (will be a lot of cross training amongst the rack& stack and fiber testing team) Rack & stack is priority OR will consider candidates who have strong fiber

Baltimore Police Department Street, MD Today

Class Description THIS IS A NON-CIVIL SERVICE POSITION Salary Range: 50,013-60,785 Annually Description: The Baltimore City

Thriveworks Davie, FL Today

Thriveworks is currently seeking Licensed Clinicians to provide a mix of telehealth and face-to-face sessions in Davie, FL. Thriveworks is a clinician-founded national private practice group with