Provider Enrollment Research Specialist

Job Summary

Reviewing and verifying provider enrollment denials, the full-time Provider Enrollment Research Representative will utilize various research tools to expedite resolution and communicate necessary actions to correct payment issues in a remote setting.

Key responsibilities

• Monitor and review payment denials using the Enterprise Task Manager
• Contact carriers and assemble documentation for appeals and claims inquiries
• Report errors and new procedures that impact claims processing to management

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
• General knowledge of ICD and CPT coding
• Intermediate computer skills, particularly in Excel