Data Provider Enrollment Specialist

2 months ago


Phoenix, United States Alpine Solutions Group Full time

MUST:

  • Bachelors degree
  • MUST have experience with SQL reports
  • Experience or knowledge of a claims clearing house
  • Ability to manage 3 people
  • Experience managing tables, authorized to add payors to the systems, manage the backend part of the system
  • Understanding of healthcare Billing applications
  • Experience adding new providers into tables within the software
  • In depth knowledge of EDI standards for healthcare:
  • Hippa
  • Aca
  • X12
  • ANSI standards
  • 837 and 835 reimbursement
  • 270 and 271 claims standards
  • Technical ability related to payor enrollment, Knowledge of healthcare reimbursement, Payor policies and regulatory requirements
  • Knows how claims and payments move electronically between parties

Plus:

  • Has worked with software such as: Zoll or Tritech
  • Has worked with the billing software called centricity EDI

DAY TO DAY:

Our fast growing healthcare client in Phoenix, AZ is seeking a Data Provider Enrollment Specialist to join their team as a full-time employee. The Specialist sets up, maintains, and supports the EDI processes to include business analysis, configuration, coding, peer and quality assurance testing, and final documentation. This person will also apply professional experience, including analysis, process design, modification, configuration, data mapping and maintenance of application programs, integrated systems, and software solutions.



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