Provider Enrollment Specialist at Della Infotech
Irving, TX 75039
About the Job
JOB DESCRIPTION
- 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's correspondence and unpotable
- Participates in company-sponsored enrollment/credentialing meetings and other educational activities
- Participates in Billing System Training exercises and updates
- Assists in training on the Billing System software package when necessary
- Serves as a Superuser of the Billing System to be available to answer questions from the various clinics
- Follows the CHRISTUS guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI)
- Maintains strict confidentiality
- Uses oral and written communication skills to effectively convey ideas in a clear, positive manner that is consistent with the CHRISTUS Mission
- Maintains established CHRISTUS policies, procedures, objectives, quality assurance, safety, environmental, and infection control.
- Implements job responsibilities in a manner that is consistent with the CHRISTUS Mission and Code of Ethics and supportive of CHRISTUS Physician Group’s cultural diversity objectives.
- Performs other related work as required.
QUALIFICATIONS:
- High School Diploma
- 1-3 years of Payer Enrollment experience
- Solid knowledge and utilization of PC applications to include WORD, EXCEL, ACCESS
- Excellent written and verbal communication skills
- Excellent organization and planning skills with demonstrated teamwork skills
- Proven ability to interact with all levels of management and other Associates
Salary
26 - 27 /hour