Job Title: Provider Enrollment Specialist - Onsite
Job ID: 75832
Location: Irving, Texas
What you will be doing: - 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
- 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 unpostables
- Participates in company sponsored enrollment/credentialing meetings and other educational activities
- Participates in Billing System Training
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