Provider Enrollment Specialist (4367) PATIENT ACCOUNTS COPR OFFI
About The Position
The Provider Enrollment Specialist, under the supervision of the Assistant Director of Patient Financial Services, performs a variety of duties related to provider payer enrollment. This role involves accurately completing and submitting enrollment applications, responding to carrier enrollment, revalidations, update requests, advance disclosures of ownership (ADO), or any other enrollment-related requests. The specialist will maintain accurate tracking of the enrollment process and contact carriers to expedite the enrollment process or correct enrollment errors. Additionally, the role includes researching and resolving enrollment/certification claim errors and preliminary/EDI claim submission errors, making account adjustments and corrections as needed, and communicating effectively and professionally. The specialist will independently monitor workflow, provide project and clerical assistance as needed, and perform other duties as assigned.
Requirements
- Formal training which will probably be indicated by a high school diploma or equivalent.
- Good typing skills and mathematical calculation ability.
- Good verbal and written communication skills.
- Good phone etiquette.
- Strong organizational skills and ability to work independently.
- Detail oriented.
- Ability to meet deadlines.
- Ability to coordinate multiple projects simultaneously.
- Proficient with Microsoft Word and Excel.
- Must possess a valid Kentucky Driver’s License.
- Ability to move, traverse, position self-remain in a stationary position and negotiate steps for up to eight hours per day.
- Ability to lift up to 25 pounds.
- Use basic office equipment.
- Ability to perform repetitive motions.
- Ability to stand/walk/sit for up to 10 hours per day.
- Visual and auditory acuity.
- Ability to drive an automobile.
- Attendance is an essential function of the job.
Nice To Haves
- A desired minimum of 2 years of health care provider enrollment experience.
- Knowledge of medical coding.
- Knowledge of third party fee profiles and reimbursement mechanisms.
- Knowledge of medical terminology and coding procedures.
- Knowledge of credentialing and health care claims software a plus.
Responsibilities
- Accurately completes and submits enrollment applications.
- Responds to carrier enrollment, revalidations, update requests, advance disclosures of ownership (ADO), or any other enrollment-related requests.
- Maintains accurate tracking of the enrollment process.
- Contacts carriers to expedite the enrollment process or to correct enrollment errors.
- Researches and resolves enrollment/certification claim errors and preliminary/EDI claim submission errors.
- Makes account adjustments and corrections as needed.
- Communicates effectively and professionally.
- Independently monitors workflow.
- Provides project and clerical assistance as needed.
- Performs other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
