Provider Enrollment Specialist

Job Summary

Reviewing and verifying provider enrollment denials, the full-time Provider Enrollment Research Representative will utilize research tools to expedite resolutions and communicate necessary actions to correct payment issues while working remotely.

Key responsibilities

• Monitor and review payment denials in the Enterprise Task Manager (ETM)
• Utilize various research tools, including telephone and carrier websites, to resolve 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 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