Provider Enrollment Analyst

2 weeks ago


Phoenix, Arizona, United States Alpine Solutions Group Full time

Key Qualifications:

  • Bachelor's degree required
  • Proven experience with SQL reporting
  • Familiarity with claims clearinghouses
  • Experience in managing a team of three
  • Proficient in managing databases, with authority to add payors to systems and oversee backend operations
  • Solid understanding of healthcare billing applications
  • Experience in adding new providers to software tables
  • Comprehensive knowledge of EDI standards relevant to healthcare:
    • HIPAA
    • ACA
    • X12
    • ANSI standards
    • 837 and 835 reimbursement formats
    • 270 and 271 claims standards
  • Technical expertise in payor enrollment processes, including knowledge of healthcare reimbursement, payor policies, and regulatory standards
  • Understanding of electronic claims and payment transactions

Preferred Qualifications:

  • Experience with software such as Zoll or Tritech
  • Familiarity with Centricity EDI billing software

Daily Responsibilities:

Alpine Solutions Group is looking for a dedicated Data Provider Enrollment Specialist to enhance our operations. This role involves establishing, maintaining, and supporting EDI processes, which includes business analysis, configuration, coding, quality assurance testing, and comprehensive documentation. The Specialist will leverage their professional expertise in analysis, process design, modification, configuration, data mapping, and maintenance of integrated systems and software solutions.



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