Provider Enrollment Specialist 1

The role involves analyzing, preparing, reviewing, monitoring, and maintaining healthcare contract documents, including enrollment changes and updates. The position interfaces with internal and external customers such as crew members and hospitals, focusing on Medicaid, private insurance billing provider enrollment, and payer reimbursement structures.

Location: Canada, United States

Salary: USD $38,675.00–$56,125.00/Yr.

Responsibilities

• Manage and track Medicaid / Private Insurance billing provider enrollment application agreements.
• Ensure all billing related provider enrollment application agreements include initial enrollments, changes, and updates.
• Communicate with internal and external customers including medical and operational crew members.
• Manage and maintain provider listings for Medicaid, Medicaid HMO, and Private Insurance.
• Compile and maintain standardized company documents/attachments.
• Maintain up-to-date knowledge of various PPO, HMO, Medicare, Medicaid, and other payer reimbursement structures.
• Perform other duties as assigned.

Requirements

• Associate’s degree (A.A.) or equivalent from two-year college or technical school.
• One to three years’ experience in healthcare contracts/agreements and/or training.
• Experience in billing, data integrity, and collection functions for healthcare providers (preferred).
• Knowledge of PPO, HMO, Medicare, Medicaid, and other payer reimbursement structures.
• Knowledge and understanding of claim processes.
• Proficient in data analysis and relational databases, report development using complex queries.

Benefits

• Industry-leading benefits (details available on benefits page).

Additional Information

• Regular scheduled attendance is required.
• Position has no supervisory responsibilities.
• Travel percentage: 0%.