Provider Enrollment Claims Specialist

3 weeks ago


Dallas, United States SCP Health Full time
Description

At SCP Health, what you do matters.As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.

Why you will love working here:
  • Strong track record of providing excellent work/life balance
  • Comprehensive benefits package and competitive compensation
  • Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect
What you'll be doing:

The Provider Enrollment Claims Specialist directly impacts the financial stability of the Company because he/she is the SCP Health representative who researches and resolves the provider enrollment claim denials with Government and Commercial Payors. Working in collaboration with the Provider Enrollment Team, the Provider Enrollment Claims Specialist, using his/her knowledge of SCP Health policies in conjunction with insurance carrier billing and enrollment requirements works to correct issues that caused claims to deny and rebill corrected claims to receive payment for our providers' services.
  • Serve as the primary contact for Provider Enrollment claim denials with payors, SCP Medical Collections, Revenue Integrity, Systems, and Managed Care departments.
  • Review Provider Enrollment denials by assigned payors daily.
  • Contact payors to get clear understanding of denial and changes needed to receive payment.
  • Prepare appeals, when necessary, when claim denials are payor errors.
  • Document all correspondence with payors in the System.
  • Provide regular feedback to Manager based on research and calls made to payors
  • Monitor changes to payor requirements through payor websites, bulletins, emails, etc and communicate any changes to Manager to ensure changes are made wherever applicable.
  • Maintain production requirements determined by Manager.
  • Collaborate with the Enrollment team to ensure changes are made when provider enrollment errors occur.
What we are looking for:
  • Minimum 3 years' experience in Healthcare Revenue Cycle
  • Knowledge of Payor Credentialing processes, both Par and Non-Par.
  • Knowledge and understanding of Taxonomy codes.
  • Knowledge of CMS Regulations and guidelines.
  • Thorough understanding of Explanation of Benefits
  • Agility in managing multiple priorities with strong organizational and time management skills.
  • Proficient in Microsoft Office applications including Word and Excel.
  • Ability to foster a cooperative and respectful work environment.
  • Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
  • Ability to communicate effectively both orally and in writing.
  • HS Diploma required.
  • 2 years of college preferred. Degree in Healthcare Administration or Business Administration
  • Experience working with National Provider Identifier database and process, preferred.
  • Experience working with Medicare, Medicaid or any Commercial payor, preferred.
  • Experience working Credentialing/Provider Enrollment denials helpful, preferred.
  • Centricity/IDX, Athena or other similar medical billing system preferred, preferred.
To learn more about SCP Health, please visit:
www.scp-health.com

Join our social circle:
  • Check out our LinkedIn Page
  • Like us on Facebook
  • Follow us on Twitter

SCP Health is an Equal Opportunity Employer.

INDJV
#LI-SC1


  • Dallas, United States Vaco Full time

    Comp: $23/hr - $27/hr based on experience Work schedule: On-site 5 days/wk Here are some more details: - Act as liaison between enrollment entity and provider - Communicate with Medicare/Medicaid and commercial payers - Work with Revenue Cycle to resolve AR issues - Complete enrollment applications for the providersDesired Skills and ExperienceComp: $23/hr -...


  • Dallas, United States Vaco Full time

    Comp: $23/hr - $27/hr based on experience Work schedule: On-site 5 days/wk Here are some more details: - Act as liaison between enrollment entity and provider - Communicate with Medicare/Medicaid and commercial payers - Work with Revenue Cycle to resolve AR issues - Complete enrollment applications for the providersDesired Skills and ExperienceComp: $23/hr -...


  • Dallas, United States Vaco Full time

    Comp: $23/hr - $27/hr based on experience Work schedule: On-site 5 days/wk Here are some more details: - Act as liaison between enrollment entity and provider - Communicate with Medicare/Medicaid and commercial payers - Work with Revenue Cycle to resolve AR issues - Complete enrollment applications for the providersDesired Skills and ExperienceComp: $23/hr -...


  • Dallas, United States Employer Direct Healthcare Full time

    Job Overview The Provider Claims Assistant supports the billing and claims department by managing the data entry process to ensure contracts and records are up to date and accurate. This role will play a critical role by collecting and processing claims data, coordinating with providers, and ensuring timely and accurate payment processing. The Provider...


  • Dallas, United States Employer Direct Healthcare Full time

    Job Overview The Provider Claims Assistant supports the billing and claims department by managing the data entry process to ensure contracts and records are up to date and accurate. This role will play a critical role by collecting and processing claims data, coordinating with providers, and ensuring timely and accurate payment processing. The Provider...


  • Dallas, Texas, United States UnitedHealth Group Full time

    Serve as primary contact as it relates to all enrollment tasks for assigned book of business, which include multiple group customers; maintain satisfied customers by providing superior service and practice attention to detail in various responsibilit Enrollment, Specialist, Microsoft, Remote, Health, Customer Service, Healthcare, Education


  • Dallas, United States Vaco Full time

    We are looking for an Enrollment Specialist who can start ASAP! This is a short-term contract that is located onsite in Dallas, TX. Key Details: Comp: $20.00/hr - $27.00/hr based on experience Work schedule: On-site 5 days/wk Job Summary Act as liaison between enrollment entity and provider Communicate with Medicare/Medicaid and commercial payers Work with...


  • Dallas, Texas, United States Collabera Full time

    Home Search Jobs Job Description Enrollment Specialist Contract: Dallas, Texas, US Salary: $23.00 Per Hour Job Code: End Date: Days Left: 21 days, 3 hours left Apply URGENT HIRING for ENROLLMENT SPECIALIST at DALLAS, TX at $23/hr. Job Description:The individual will be responsible for conducting visits to residential settings, ensuring State site...

  • Enrollment Specialist

    3 weeks ago


    Dallas, United States Collabera Full time

    Description Home Search Jobs Job Description Enrollment Specialist Contract: Dallas, Texas, US Salary: $23.00 Per Hour Job Code: 350060 End Date: 2024-06-28 Days Left: 28 days, 3 hours left Apply URGENT HIRING for ENROLLMENT SPECIALIST at DALLAS, TX at $23/hr. Job Description: The individual will be responsible for conducting visits to residential...


  • Dallas, United States Collabera Full time

    Description Home Search Jobs Job Description Enrollment Specialist Contract: Dallas, Texas, US Salary: $23.00 Per Hour Job Code: 350060 End Date: 2024-06-28 Days Left: 12 days, 3 hours left Apply URGENT HIRING for ENROLLMENT SPECIALIST at DALLAS, TX at $23/hr. Job Description: The individual will be responsible for conducting visits to residential...

  • Enrollment Specialist

    1 month ago


    Dallas, United States 160 Driving Academy Full time

    Job DescriptionJob DescriptionWhether you see yourself in sales, business development, customer service, retail management, or operations, as a 160 Enrollment Specialist you will have exposure to all facets of the business and a career full of growth opportunities. 160 Driving Academy is the nation's largest CDL training provider and fastest growing...

  • Enrollment Specialist

    4 weeks ago


    Dallas, United States 160 Driving Academy Full time

    Whether you see yourself in sales, business development, customer service, retail management, or operations, as a 160 Enrollment Specialist you will have exposure to all facets of the business and a career full of growth opportunities. 160 Driving Academy is the nation's largest CDL training provider and fastest growing vocational school. Over the last 10...

  • Claims Specialist

    4 weeks ago


    Dallas, United States CorVel Full time

    The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This position is a hybrid role. ESSENTIAL...


  • Dallas, United States American National Full time

    Press Tab to Move to Skip to Content Link Select how often (in days) to receive an alert: Select how often (in days) to receive an alert: American National is seeking a highly skilled and motivated Casualty Claims Specialist to join our team. The ideal candidate will have a strong background in adjusting liability claims, excellent analytical, injury...

  • Enrollment Specialist

    1 month ago


    Dallas, United States Pinecrest Consulting Full time

    Group Health Insurance Enroller About Pinecrest Consulting: At Pinecrest Consulting, we're more than just a team; we're a community. Recently ranked the #7 Top Workplaces among small businesses by the Dallas Morning News, we pride ourselves on a culture that fosters growth, innovation, and a deep sense of commitment to our clients. As a full-service...

  • Enrollment Specialist

    1 month ago


    Dallas, United States Pinecrest Consulting Full time

    Group Health Insurance EnrollerAbout Pinecrest Consulting:At Pinecrest Consulting, we're more than just a team; we're a community. Recently ranked the #7 Top Workplaces among small businesses by the Dallas Morning News, we pride ourselves on a culture that fosters growth, innovation, and a deep sense of commitment to our clients. As a full-service healthcare...

  • Enrollment Specialist

    3 weeks ago


    Dallas, United States Pinecrest Consulting Full time

    Group Health Insurance EnrollerAbout Pinecrest Consulting:At Pinecrest Consulting, we're more than just a team; we're a community. Recently ranked the #7 Top Workplaces among small businesses by the Dallas Morning News, we pride ourselves on a culture that fosters growth, innovation, and a deep sense of commitment to our clients. As a full-service healthcare...


  • Dallas, United States Foster CM Group Full time

    Job DescriptionJob DescriptionClaims Avoidance SpecialistA critical aspect of projects managed by Foster CM Group is managing risk. We are seeking a Claims Avoidance Specialist to use appropriate claims analysis techniques to analyze critical paths and predict possible delays. This allows our Project Managers to mitigate delay impacts and negotiate necessary...


  • Dallas, United States UnitedHealth Group Full time

    Serve as primary contact as it relates to all enrollment tasks for assigned book of business, which include multiple group customers; maintain satisfied customers by providing superior service and practice attention to detail in various responsibilit Enrollment, Specialist, Microsoft, Remote, Health, Customer Service, Healthcare, Education


  • Dallas, United States UnitedHealth Group Full time

    Use your Sharp Analytical Skills to triage and research provider dispute inquires to determine root cause and identify potential trends Owning the issue from inception to resolution by engaging and partnering with appropriate operational partners Ana Claims Specialist, Claims, Specialist, Microsoft, Remote, Senior, Technology, Healthcare