Provider Enrollment Specialist

1 week ago


Irving, Texas, United States Impresiv Health Full time
Job Summary

We are seeking a highly skilled Provider Enrollment Specialist to join our team at Impresiv Health. As a key member of our healthcare consulting team, you will be responsible for coordinating Medicare and Medicaid enrollment/re-enrollment and managed care credentialing and contracting processes for providers.

Key Responsibilities
  • Enrollment and Credentialing: Coordinate Medicare and Medicaid enrollment/re-enrollment and managed care credentialing and contracting processes for providers.
  • Administrative Support: Serve as administrator for billing system and assist practices with system issues.
  • Data Management: Maintain NPI files and provider numbers.
  • Customer Service: Serve as customer service liaison and interact with patients, insurance carriers, the billing vendor, and practice personnel concerning patient accounts.
  • Financial Management: Monitor accounts receivable to maintain appropriate levels and review payments to maximize reimbursement.
  • Reporting and Analysis: Generate various reports to identify outstanding claims issues with provider numbers and non-payment.
  • Communication and Education: Communicate information to appropriate personnel and educate staff on corrections, e.g., front-end entry errors in a positive, constructive manner.
  • Contract Management: Collect and review managed care contracts for correct billing and payment terms.
  • Problem Resolution: Identify problem accounts and follow through to completion.
  • Compliance and Confidentiality: Follow the company guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI), and maintain strict confidentiality.
  • Teamwork and Communication: Use oral and written communication skills to effectively convey ideas in a clear, positive manner that is consistent with the company's Mission.
Requirements
  • Education: High School Diploma required.
  • Experience: 1-3 years of Payer Enrollment experience required.
  • Skills: Solid knowledge and utilization of PC applications to include Word, Excel, Access; excellent written and verbal communication skills; excellent organization and planning skills with demonstrated teamwork skills; proven ability to interact with all levels of management and other Associates.


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