What are the responsibilities and job description for the Provider Enrollment Specialist position at AMAC?
In this position, you will provide administrative and technical support for physician billing services. Responsibilities include:
Provider enrollment support including preparing initial provider enrollment and re-enrollment forms required for insurance carrier participation. Enroll providers for electronic funds transfer (EFT) and electronic remittance advice (ERA). Maintain and regularly attest to data accuracy in provider enrollment data bases including CAQH, Better Doctor, and other insurance carrier websites as required by insurance carriers.
Contact insurance companies to follow-up on status of applications and coordinate effective dates with providers/staff. Communicate provider enrollment status to physicians and staff.
Maintain records of all provider enrollment activities including all applications, application status and provider participation effective dates. Maintain up to date documents and credentials for all physicians and obtain updated documents as needed.
Maintain physician fee schedules in accordance with established coding practices and governmental regulatory requirements. Configure and maintain fee schedules in practice management software. Request and analyze fees schedules annually by payer per provider. Assist with payer fee schedule negotiations and corrections. Analysis of payer performance based on payments versus contracted fee schedule.
Special projects as assigned
Requires persistence, demonstrated analytical and problem solving skills, ability to manage priorities and meet deadlines. Strong verbal and written communications skills are required. Proficiency with MS Office and Adobe are required. Must be able to type 45 wpm and be proficient in 10-key. Two years provider enrollment experience or medical office experience preferred.