Demo

Provider Enrollment Specialist

TEEMA
Irving, TX Full Time
POSTED ON 2/7/2025
AVAILABLE BEFORE 5/3/2025

Job Title : Provider Enrollment Specialist - Onsite Job ID : 75832 Location : Irving, Texas What you will be doing :

  • Coordinates Medicare and Medicaid enrollment / re-enrollment and managed care credentialing and contracting processes for providers.
  • Serves as administrator for billing system and assists practices with system issues.
  • Maintains NPI files and provider numbers.
  • Serves as customer service liaison.
  • Monitors accounts receivable to maintain appropriate levels and reviews payments to maximize reimbursement.
  • Interacts with patients, insurance carriers, the billing vendor and practice personnel concerning patient accounts.
  • Performs all functions in a courteous and professional manner
  • 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 correspondence and unpostables
  • Participates in company sponsored enrollment / credentialing meetings and other educational activities
  • Participates in Billing System Training

For more information about TEEMA and to consider other career opportunities, please visit our website at www.teemagroup.com

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