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Provider Enrollment Analyst
2 months ago
Essential Qualifications:
- Bachelor's degree required
- Proven experience with SQL reporting
- Familiarity with claims clearinghouses
- Ability to supervise a team of three
- Experience in managing databases, including authorization to add payors and oversee backend operations
- Comprehensive understanding of healthcare billing applications
- Experience in integrating new providers into software databases
- Extensive knowledge of EDI standards in healthcare, including:
- HIPAA
- ACA
- X12
- ANSI standards
- 837 and 835 reimbursement processes
- 270 and 271 claims standards
- Technical expertise in payor enrollment, healthcare reimbursement processes, payor policies, and regulatory compliance
- Understanding of electronic claims and payment transactions
Preferred Qualifications:
- Experience with software platforms such as Zoll or Tritech
- Familiarity with Centricity EDI billing software
Role Overview:
Alpine Solutions Group is looking for a dedicated Data Provider Enrollment Specialist to contribute to our expanding healthcare operations. This role involves establishing, maintaining, and enhancing EDI processes, which encompasses business analysis, configuration, coding, quality assurance testing, and comprehensive documentation. The ideal candidate will leverage their professional background in analysis, process design, modification, configuration, data mapping, and the upkeep of application programs and integrated systems.