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Provider Enrolment Specialist

Macpower Digital Assets Edge Private Limited

  • Irving, TX
  • 1 day ago
  • $20–$24.13 Per Hour

Highlights

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. 3+ years of experience required in Medicare and Medicaid enrollment/re-enrollment and managed care credentialing and contracting processes for providers.

Numbers & Facts

LocationIrving, TX
Salary$20–$24.13 Per Hour

Description

Summary:
  • 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.
Requirements:
  • Excellent written and verbal communication skills.
  • Excellent organizational and planning skills with demonstrated teamwork and vendor management skills.
  • 3+ years of experience required in Medicare and Medicaid enrollment/re-enrollment and managed care credentialing and contracting processes for providers.
Responsibilities:
  • 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 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 updates as necessary.
  • Participates in company-sponsored enrollment/credentialing meetings and other educational activities.
  • Participates in billing.

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