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Provider Enrollment Research Representative in Knoxville, TN at TeamHealth

Date Posted: 9/5/2023

Job Snapshot

Job Description


This position is responsible for reviewing claims rejected due to a provider or claims issues. Maintains accuracy and production to ensure invoices are being processed efficiently.



§ Reviews ETM task list assignment, comments, and processing specific provider-related denials.

§ Reviews denials to determine appropriate action based on carrier requirements.

§ Identifies and reports provider termination/enrollment issues per policy guidelines.

§ Identifies and reports carrier-specific claim issues per policy guidelines.

§ Assembles and forwards appropriate documentation to the senior representative for provider and carrier-related issues.

§ Reviews carrier provider manuals for billing updates as needed and reports these updates to the Senior/Supervisor.

§ Reports any consistent errors found during the review that affect claims from being processed correctly.

§ Participates in department meetings with the Accounts Receivable Team

§ Turns to Senior/Supervisor for unusual circumstances that may include write-offs, fee schedules, claims, etc.

§ Performs all duties as directed by Supervisor, and Accounts Receivable Manager


Job Requirements


§ 1-2 years of previous medical billing experience required with an emphasis on research of provider and/or claims-related issues. Knowledge of physician billing policies and procedures

§ Computer literate

§ Ability to work in a fast-paced environment

§ Excellent organizational skills

§ Ability to work independently



§ High school diploma or equivalent.




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