Diagnostic Radiology & Imaging, LLC (DRI)

Job Description

EOE AA M/F/Vet/Disability Employer

Description

The Enrollment Specialist is a critical position in the Revenue Cycle Department. Accurate enrollments are essential for accurate and timely collections from payers. This position will be responsible for all enrollment items with Government and Commercial payers. This position will work closely with the Revenue Cycle Manager to ensure optimal billing.

Duties and Responsibilities

• Research, verify and document provider enrollment information through various agencies and licensing board
• Responsible for new enrollments for physicians and locations with Government and Commercial payers, ensuring applications are completed accurately and timely and that the required supporting materials have been provided.
• Responsible for re-credentialing and/or re-validation of physicians with Government and Commercial payers
• Submit dis-enrollments and location terminations within the established payer guidelines.
• Collaborate with physicians and other vendor/partners on CAQH accesses and verifications
• Work with external or partnering enrollment specialist on enrollment statuses and issues
• Work with RCM Manager to ensure billing system information is current for accurate claims submission
• Assist with AR denial follow up for Provider Enrollment issues including trend identification and resolution
• Develop reporting and tracking processes to ensure timely enrollment and follow up
• Audit payer enrollments and submit updates or corrections for any identified issues
• Stay educated on government regulations and payer policies and processes related to enrollment

· Recommend and assist in the development of policies, procedures, and systems to improve workflows, efficiencies, and to meet all goals/metrics that are set for the department

· Assist with other billing/collection duties and projects as needed

• Attend training sessions as required to maintain system knowledge

· Maintain confidentiality of patient information and adhere to HIPAA regulations

• Promote a culture that reflects the organization’s values, encourages good performance, and enhances productivity.

· Other duties as assigned.

Qualifications

Education: High School diploma or equivalent; Associate degree in medical or business preferred

Experience/Skills: 1 to 3 years’ experience in Provider Enrollment/Credentialing. Knowledge of enrollments with Government Payers is required. Must also possess the following:

o Attention to detail.

o Have the ability to prioritize independently

o Ability to multi-task in a busy office environment

o Proficient customer service skills

o Intermediate knowledge of MS Office, Email

o Ability to comprehend and utilize Electronic Medical Record System

Knowledge: Consistently model AIDET principles, service excellence and service recovery. Consistently demonstrate commitment to safe practices while abiding by all OSHA and HIPAA guidelines. Knowledge of computer spreadsheets and other related applications. Knowledge of provider credentialing/accreditation/insurance regulations, policies, guidelines, and standards.

Physical Demands: The flow of work and character of duties involve remaining in a seated stationary position and performing keyboard operations constantly; communicating with internal and external stakeholders constantly; and moving/traversing about the office or remaining in an upright stationary position on an occasional basis. Additionally, the person in this role may seldom climb stairs or position oneself as necessary to access resources pertinent to one’s desk/computer/files. Visual attention is necessary because frequent near acuity for computer usage is required and far acuity is occasionally needed to assist with following PowerPoint presentations. Intermittently, the ability to distinguish color is warranted. The person in this role needs to be able to detect smells for safety-related purposes on occasion. The position also requires an individual to be able to transport a laptop computer, equipment and files weighing approximately 10-15 lbs.

Working Conditions: Moderate noise associated with a typical work environment (computers, printers, and light traffic) is characteristic of this job.

Conditions of employment: This role is an onsite role in our Billing Department, Covid Vaccination, compliance with OSHA and HIPAA guidelines, wear all required Personal Protective Equipment. Adherence to Mission, Vision, and Values of DRI and professional representation of DRI.

The above statements are intended to describe the general nature and level of work performed by employees in this position and other duties not listed may be assigned. They are not intended to be an exhaustive list of all duties, responsibilities and qualifications of employees assigned to this job. To perform this job successfully, an individual must be able to perform the essential job functions satisfactorily. Reasonable accommodation may be made to enable individuals with disabilities to perform the primary job functions herein described.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• 8 hour shift
• Day shift

Ability to Commute:

• Greensboro, NC 27405 (Required)

Work Location: Hybrid remote in Greensboro, NC 27405