Provider Enrollment Research Specialist

Job Summary

Working remotely in a full-time capacity, the Provider Enrollment Research Specialist will review, organize, and verify payment denials related to provider enrollment, utilizing various research tools to expedite resolutions and communicate necessary actions for correction.

Key responsibilities

• Monitor and review payment denials assigned in the Enterprise Task Manager (ETM)
• Utilize telephone and carrier websites to expedite resolution of denied claims
• 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 literacy, particularly in Excel
• General knowledge of ICD and CPT coding