Provider Enrollment Research Specialist

Job Summary

Working remotely in a full-time capacity, the Provider Enrollment Research Representative will review, organize, and verify payment denials related to provider enrollment while communicating necessary actions to resolve these issues.

Key responsibilities

• Monitor and review payment denials using the Enterprise Task Manager (ETM)
• Utilize various research tools, including telephone and carrier websites, to expedite issue resolution
• Assemble and forward documentation for appeals and communicate with carriers regarding denied claims

Required qualifications

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