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 while communicating necessary actions for resolution.

Key responsibilities

• Monitor and review payment denials in the Enterprise Task Manager (ETM)
• Utilize various research tools to expedite resolution of claims issues
• Assemble 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, focusing 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