Provider Enrollment Associate- Remote

Med-MetrixParsippany-Troy Hills, NJ
2dRemote

About The Position

The Provider Enrollment Associate is responsible for credentialing/enrolling new and established health care providers and maintenance of required information.

Requirements

  • High School graduate or equivalent required
  • Minimum two years of provider enrollment experience
  • Knowledge of Microsoft Office Suite, Outlook, Excel, CAQH
  • Excellent verbal and written communication skills
  • Strong interpersonal skills, ability to communicate well at all levels of the organization
  • Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
  • High level of integrity and dependability with a strong sense of urgency and results oriented
  • Excellent written and verbal communication skills required
  • Gracious and welcoming personality for customer service interaction
  • Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.

Nice To Haves

  • Billing knowledge and experience preferred

Responsibilities

  • Communicates with providers to explain process and sign applications
  • Collects, updates, maintains necessary provider information and documentation and verifies the information where possible
  • Establishes and maintains data entry in CAQH
  • Prepares provider enrollment applications for all initial applications and re-credentialing in a timely and complete manner
  • Verifies provider and group information with insurance companies (addresses, contracted plans, provider ID numbers, etc.)
  • Coordinates information for enrollment and termination of all providers
  • Handles enrollment with Medicare, Medicaid, commercial insurances
  • Contributes to the departmental process and procedures with a collaborative approach
  • Works department client WQ’s and smart feeds where applicable
  • Maintains provider enrollment mailbox and completes actions and follow up
  • Performs other duties as requested
  • Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
  • Understand and comply with Information Security and HIPAA policies and procedures at all times
  • Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
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