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Provider Enrollment Coordinator in Raleigh, NC at TeamHealth

Date Posted: 11/7/2018

Job Snapshot

Job Description

JOB DESCRIPTION OVERVIEW:

The Provider Enrollment Coordinator supports the Provider Enrollment Department by performing clerical duties, special projects, and general tasks. The Provider Enrollment Coordinator receives all notifications that a provider needs to be enrolled, identifies payer and facility requirements and generates required applications. This position is responsible for all payer research, application generation, preparation of the application, sending to the provider for completion and following up for missing paperwork.



ESSENTIAL DUTIES AND RESPONSIBILITIES:

 

  • Proactively conduct payer research, complete payer profile sheet and secure all payer specific documents/requirements.
  • Accurately complete, submit, log and follow up on payer specific provider enrollment forms.
  • Complete PECOS enrollment.
  • Work collaboratively with various departments to secure documents necessary for enrollment.
  • Complete provider number matrix and notify appropriate billing company with all information necessary to release claims.
  • Facilitate resolution of billing vendor enrollment inquiries in a professional and timely manner.
  • Provide enrollment update reports to program staff.
  • Ensure regulatory compliance and safety/privacy regulations are maintained by the Company as it pertains to enrollment of physicians.
  • Maintain strict confidentiality of business affairs and physician/patient information. Comply with HIPAA regulations in all aspects of daily duties.
  • Serve as a back-up for billing personnel staying up to date on all billing related processes and procedures.
  • Work closely with credentialing and program staff across all boundaries to improve internal policies and procedures as it relates to the enrollment process to maintain productive team-oriented environment.
  • Perform analysis, special projects and other duties as required and assigned by the Provider Enrollment Supervisor. These may, on occasion, be unrelated to the position described here.

 

Job Requirements

 

  • A minimum of 2-3 years experience handling physician enrollment into Medicare, Medicaid and third party payers.
  • Knowledge and experience with Medicare, Medicaid, managed care enrollment, billing processes and Council for Affordable Quality Healthcare (CAQH) online database data entry.
  • Must have experience interacting with health care professionals and physicians.
  • Proven ability to support multiple projects and work with multiple people simultaneously required.
  • Experience with enrollment and billing/collections in a hospital and/or medical practice setting ideal.
  • Advanced computer skills required.
  • Intermediate level excel and spreadsheet creation.
  • Must have ability to appropriately handle confidential information.
  • Good verbal, mathematical and communication skills are essential.
  • Must be detail oriented.
  • Knowledge of HIPAA and privacy regulations.
  • Effective organizational and interpersonal skills as well as the ability to multi- task and problem solve using critical thinking.
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