Perform all provider enrollment related procedures for physicians/mid-level providers to ensure groups can submit claims to insurance carriers for reimbursement.
Duties and Responsibilities
1. Process provider enrollment applications for providers/groups
2. Research insurance provider enrollment requirements by state
3. Enter group/individual data to credentialing system
4. Prepare and submit provider enrollment applications to insurance carriers
5. Follow-up on provider enrollment applications with provider, insurance company or client sites
6. Interact with providers via phone or email as needed
7. Collaborate with Account Managers to resolve provider denials
8. Update/Maintain Provider Enrollment Credentialing System
9. Attends conference calls with clients as requested
10. Adhere to the Code of Conduct and be familiar with all compliance policies and procedures stored in LogixGarden relevant to this position
To perform this job successfully, an individual must be able to perform each duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities perform the duties.
Education (Degrees, Certificates, Licenses, Etc.)
High School Diploma or equivalent combination of education and experience required.
Prior word processing, spreadsheet and internet software experience including proficiency with MS Excel and MS Word required.
One to two years related experience preferred.
Specific Job Knowledge, Skill and Ability
1. Ability to add, to subtract, multiply and divide in all units of measure; this ability will encompass using whole numbers, common fractions and decimals
2. Ability to compute rates, ratios and percentages
3. Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedural manuals
4. Ability to write routine reports and correspondence
5. Ability to communicate effectively verbally and in writing
6. Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form
7. Ability to deal with problems involving several concrete variables in standardized situations
8. Specific vision abilities required by this job include close vision
9. Ability to sit for prolonged periods of time, use hands, talk, hear and occasionally walk and reach with hands or arms
Principals only. Recruiters, please don't contact this job poster.
do NOT contact us with unsolicited services or offers