MD
Provider Enrolment Specialist
Macpower Digital Assets Edge Private Limited
🇺🇸 United States
On-site
5 days ago
$20.00 – $24.13 / hour
- Athena
5 days ago
Not enough detail in this posting to match
- Coordinates Medicare and Medicaid enrollment/re-enrollment and managed care credentialing and contracting processes for providers.
- Serves as administrator for billing system and assists practices with system issues.
- Maintains NPI files and provider numbers.
- Serves as customer service liaison.
- Monitors accounts receivable to maintain appropriate levels and reviews payments to maximize reimbursement.
- Interacts with patients, insurance carriers, the billing vendor, and practice personnel concerning patient accounts. Performs all functions in a courteous and professional manner.
- Excellent written and verbal communication skills.
- Excellent organizational and planning skills with demonstrated teamwork and vendor management skills.
- 3+ years of experience required in Medicare and Medicaid enrollment/re-enrollment and managed care credentialing and contracting processes for providers.
- Collects and maintains data on providers for Medicare and Medicaid enrollment.
- Prepares and submits applications to Medicare and Medicaid for new provider enrollments and existing provider updates; follows up by telephone or in writing with carriers regarding application status.
- Complies with Medicare and Medicaid provider enrollment guidelines.
- Requests NPI numbers for providers and clinics as necessary and maintains NPI files.
- Follows up, either by telephone or in writing, with insurance companies and patients regarding the processing of outstanding claims and/or appeals.
- Generates various reports to identify outstanding claims issues with provider numbers and non-payment.
- Communicates information to appropriate personnel.
- Educates staff on corrections, e.g., front-end entry errors, in a positive, constructive manner.
- Collects and reviews managed care contracts for correct billing and payment terms.
- Identifies problem accounts and follows through to completion.
- Reviews Athena correspondence and updates as necessary.
- Participates in company-sponsored enrollment/credentialing meetings and other educational activities.
- Participates in billing.
Provider Enrolment Specialist · Macpower Digital Assets Edge Private Limited