Provider Enrollment Representative

Job Summary

To support healthcare claims processing, the full-time remote Provider Enrollment Research Representative will investigate provider and claim denials, analyze rejected claims, and collaborate with team members to ensure timely reimbursement and operational success.

Key Responsibilities

• Review assigned denial worklists and research provider-related claim denials
• Analyze rejected claims and determine appropriate resolutions based on payer requirements
• Identify and report provider enrollment or termination issues according to established guidelines

Required Qualifications

• 1+ year of medical billing experience focused on researching provider and/or claim-related issues
• Knowledge of physician billing policies and procedures
• Strong computer skills and proficiency navigating multiple systems
• High school diploma or equivalent