Provider Enrollment Representative

Job Summary

To support efficient provider enrollment processes, the full-time Provider Enrollment Research Representative will review and verify payment denials, communicate necessary actions for resolution, and utilize various research tools to expedite claims processing in a remote environment.

Key responsibilities

• Monitor and review payment denials using the Enterprise Task Manager
• Utilize telephone and carrier websites to resolve issues related to claims denials
• Assemble and forward documentation for appeals and provider-related issues to the appropriate departments

Required qualifications

• High school diploma or equivalent
• 1 - 3 years of experience in physician medical billing with a focus on research and claim denials
• Thorough knowledge of revenue cycle and healthcare reimbursement guidelines
• Intermediate computer skills, particularly in Excel
• General knowledge of ICD and CPT coding