Provider Enrollment Specialist

6 days ago


Irving, United States Impresiv Health Full time
Title: Provider Enrollment Specialist

Schedule: Monday-Friday 8a-5pm

Description:
The Provider Enrollment Specialist coordinates Medicare and Medicaid enrollment/re-enrollment and managed care credentialing and contracting processes for providers. Serves as administrator for billing system and assists practices with system issues. Maintains NPI files and provider numbers. Serves as customer service liaison. Monitors accounts receivable to maintain appropriate levels and reviews payments to maximize reimbursement. Interacts with patients, insurance carriers, the billing vendor and practice personnel concerning patient accounts. Performs all functions in a courteous and professional manner.

What You Will Do:
  • Collects and maintains data on providers for Medicare and Medicaid enrollment.
  • Prepares and submits applications to Medicare and Medicaid for new provider enrollments and existing provider updates.
  • Ffollows up by telephone or in writing, with carriers regarding application status.
  • Complies with Medicare and Medicaid provider enrollment guidelines.
  • Requests NPI numbers for providers and clinics as necessary and maintains NPI files.
  • Follows up, either by telephone or in writing, with insurance companies and patients regarding the processing of outstanding claims and/or appeals.
  • Generates various reports to identify outstanding claims issues with provider numbers and non-payment.
  • Communicates information to appropriate personnel.
  • Educates staff on corrections, e.g.. front-end entry errors in a positive, constructive manner.
  • Collects and reviews managed care contracts for correct billing and payment terms.
  • Identifies problem accounts and follows through to completion.
  • Reviews Athena correspondence and unpostables.
  • Participates in company sponsored enrollment/credentialing meetings and other educational activities.
  • Participates in Billing System Training exercises and updates.
  • Assists in training on the Billing System software package when necessary.
  • Serves as a Superuser of the Billing System to be available to answer questions from the various clinics.
  • Follows 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).
  • Maintains strict confidentiality.
  • Uses oral and written communication skills to effectively convey ideas in a clear, positive manner that is consistent with the company's Mission.
  • Maintains established company policies, procedures, objectives, quality assurance, safety, environmental and infection control.
  • Implements job responsibilities in a manner that is consistent with the company's Mission and Code of Ethics and supportive of company Physician Group's cultural diversity objectives.
  • Performs other related work as required.

What You Will Bring:
  • High School Diploma required.
  • 1-3 years of Payer Enrollment experience required.
  • 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.

About Impresiv Health:

Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services. We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges.

Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do provide tangible results that add immediate value, at a rate that cannot be beaten. Your success matters, and we know it.

That's Impresiv

  • Irving, United States Amtex Systems Inc. Full time

    Job Summary:The Provider Enrollment Specialist is responsible for coordinating the Medicare and Medicaid enrollment/re-enrollment and managed care credentialing processes for healthcare providers. This role also involves administering the billing system, addressing system issues for practices, maintaining provider numbers and NPI files, and acting as a...


  • Irving, United States Amtex Systems Inc. Full time

    Job Summary:The Provider Enrollment Specialist is responsible for coordinating the Medicare and Medicaid enrollment/re-enrollment and managed care credentialing processes for healthcare providers. This role also involves administering the billing system, addressing system issues for practices, maintaining provider numbers and NPI files, and acting as a...


  • Irving, United States AG Globe Services Full time

    Role: Provider Enrollment Specialist Considering making an application for this job Check all the details in this job description, and then click on Apply. Location: Irving, TX Traveler Pay Rate: Up to $24/hr Contract: 12 weeks contract with a possibility of extension Shift: 8am-5pm Hours: 40 hrs/week WHO WE ARE AG Globe Services is one of the major...


  • Irving, Texas, United States Della Infotech Full time

    Job SummaryDella Infotech is seeking a highly skilled and detail-oriented Healthcare Provider Enrollment Specialist to join our team. As a key member of our healthcare operations team, you will be responsible for ensuring the accurate and timely enrollment of healthcare providers into various insurance programs.Key ResponsibilitiesCollect and maintain...


  • Irving, United States Della Infotech Full time

    JOB DESCRIPTION Collects and maintains data on providers for Medicare and Medicaid enrollment Prepares and submits applications to Medicare and Medicaid for new provider enrollments and existing provider updates; follows up by telephone or in writing, with carriers regarding application status Complies with Medicare and Medicaid provider enrollment...


  • Irving, United States Della Infotech Full time

    JOB DESCRIPTION Collects and maintains data on providers for Medicare and Medicaid enrollment Prepares and submits applications to Medicare and Medicaid for new provider enrollments and existing provider updates; follows up by telephone or in writing, with carriers regarding application status Complies with Medicare and Medicaid provider enrollment...


  • Irving, United States AG Globe Services Full time

    Role: Provider Enrollment SpecialistLocation: Irving, TXTraveler Pay Rate: Up to $24/hrContract: 12 weeks contract with a possibility of extensionShift: 8am-5pmHours: 40 hrs/weekWHO WE AREAG Globe Services is one of the major providers of clinical and non-clinical healthcare staffing across the United States. We work with Clinical and Non-Clinical...


  • Irving, United States Crown Connect, Inc. Full time

    Job DescriptionJob DescriptionAre you passionate about providing exceptional service and creating positive experiences for customers? Do you thrive in a fast-paced environment where your communication skills and attention to detail are valued? If so, we invite you to join our dynamic team at Crown Connect, a leading customer enrollment firm dedicated to...


  • Irving, United States Ultimate Staffing Full time

    It is mainly a high inbound/outbound call, email & text role that provides assistance to inquiring students that includes program information, admission requirements, etc. with the goal of having the student submit their application to one of our programs. It is a hybrid position where the OC will work on campus 2 days/week & then from home 3 days/week and...


  • Irving, United States Ultimate Staffing Full time

    It is mainly a high inbound/outbound call, email & text role that provides assistance to inquiring students that includes program information, admission requirements, etc. with the goal of having the student submit their application to one of our programs. It is a hybrid position where the OC will work on campus 2 days/week & then from home 3 days/week and...


  • Irving, United States Ultimate Staffing Full time

    It is mainly a high inbound/outbound call, email & text role that provides assistance to inquiring students that includes program information, admission requirements, etc. with the goal of having the student submit their application to one of our programs. It is a hybrid position where the OC will work on campus 2 days/week & then from home 3 days/week and...


  • Irving, Texas, United States Ultimate Staffing Full time

    Position OverviewThe role primarily involves managing a high volume of inbound and outbound communications through calls, emails, and texts to assist prospective students. This includes providing detailed information about programs, admission criteria, and guiding students towards submitting their applications.This is a hybrid position, requiring on-campus...


  • Irving, Texas, United States Ultimate Staffing Full time

    Position OverviewThe role primarily involves high volumes of inbound and outbound communication via calls, emails, and texts, aimed at assisting prospective students with inquiries regarding program details, admission criteria, and more. The objective is to guide students towards submitting their applications for our educational programs.This is a hybrid...


  • Irving, United States Christus Health Full time

    Job Description DescriptionSummary:The Coordinator Credentialing Senior serves as the first line of defense through the functions of providing for adequate and qualified staff. Under supervision of leadership, the Coordinator Credentialing Senior is responsible for the department. Duties include ensuring compliance with regulatory and accrediting agencies,...


  • Irving, United States Exceed Healthcare Full time

    Job DescriptionJob DescriptionRole: Credentialing Specialist Job DescriptionDepartment: HRDirect Report: Director of HRSummary: Responsible for all aspects of the credentialing, re credentialing, and privileging processes for all medical providers who provide patient care as clients of Exceed Healthcare. Responsible for ensuring providers are credentialed,...


  • Irving, Texas, United States Crown Connect, Inc. Full time

    Job OverviewCrown Connect, Inc. is seeking a highly skilled and motivated Customer Acquisition Specialist to join our dynamic team. As a key member of our enrollment services team, you will play a crucial role in driving new customer acquisition and ensuring a seamless onboarding experience for our clients.Key ResponsibilitiesProduct Promotion: Highlight the...


  • Irving, United States CornerStone Staffing Full time

    CornerStone Staffing has partnered with a non-profit whose mission is focused on childhood education. We are currently recruiting for a Family Services- Qualifications Specialist. Do you have experience qualifying clients for benefits? Do you love to help others? CornerStone Staffing has your perfect job waiting for you! Job Title: Qualifications...


  • Irving, United States Exceed Healthcare Full time

    Job DescriptionJob DescriptionRole: Payer Credentialing Specialist Department: HRDirect Report: Director of HRSummary: Responsible for all aspects of the credentialing, re credentialing, and privileging processes for all medical providers who provide patient care as clients of Exceed Healthcare. Responsible for ensuring providers are credentialed,...


  • Irving, Texas, United States Carie Boyd Pharmaceuticals Full time

    Job OverviewSales Support SpecialistCarie Boyd Pharmaceuticals, a leading and rapidly expanding pharmaceutical compounding company, is on the lookout for a Sales Support Specialist. This role is integral to our customer engagement team, focusing on enhancing relationships with existing clients while collaborating with our Sales Team to optimize revenue...


  • Irving, United States Johnson Service Group Full time $25 - $35

    Job DescriptionJob DescriptionResponsibilities· Reviews and analyzes HRIS data files. Coordinates the correction of data errors for employee records that may impact the administration of employee benefits or the transmission of employee data to various third-party vendors involved in the administration of benefits and 401(k) plans.· Audits payroll...