- Educate and communicate with providers/practices the enrollment process required for payors to establish the billing process and how it relates to the provider's ability to provide patient care and reimbursement.
- Obtain and communicate NPI(National Provider Information) numbers for new practices.
- Maintain NPI numbers/practice locations in the NPI database.
- Update and maintain all required information for CAQH(Council for Affordable Quality Healthcare) profiles.
- Prepare and submit accurate applications for new practices/providers including EFT(Electronic Funds Transfer) /ERA(Electronic Remittance Advice) enrollments.
- Consistently document work assignment progress, enrollment follow-up status, and relevant in-process tasks within the specified systems and time frames.
- Validate completed enrollment information with supervisors for EPIC claim processing and revenue collection.
- Facilitate revalidation/termination applications needed for all providers/practicies following the payer requirements.
- Maintain all practice location and provider demographic changes with all insurance carriers and CAQH.
- Work with supervisors/billers on denials referencing enrollment issues.
- Maintain detailed provider enrollment files in electronic format, including electronically received documents and scanning of hard copy documents and document each stage of enrollment/re-enrollment process.
- Ongoing training to remain current on enrollment requirements.
- Work collaboratively with fellow team members to create, evaluate and maintain department workflows, processes, policies and systems.
- Provides additional status reports and updates as needed.
- Follows and maintains all confidentiality requirements with provider data.
- Other projects as assigned.
-
Chemist- Line Support
1 week ago
Nippon Paint Automotive Americas Lansing, United StatesJob Description · Job DescriptionNippon Paint Automotive Americas Inc. (NPAA) offers employees a generous earned bonus structure including monthly hourly attendance bonuses, merit increases and a annual bonus incentive plan. Employees receive 11 paid holidays per year, earn paid ...
shs-provider enrollment spec - Lansing, United States - Sparrow Health System
Description
Job Opportunity
Job ID:44007 Positions Location: Lansing, MI Job Description General Purpose of Job:
Description:
Positions Location: Lansing, MI
Job DescriptionGeneral Purpose of Job:
The Provider Enrollment Specialist works to efficiently complete/maintain provider/practice enrollments, revalidations and any demographic changes with contracted and government payers for the reimbursement of services. Establish and verify all billing information for entry into EPIC to ensure efficient revenue flow. Problem solve enrollment issues with practicies, providers and revenue cycle areas.
Essential Duties:
This job description is intended to cover the minimum essential duties assigned on a regular basis. Associates may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.
General Requirements
None
Work Experience
Two years multi-physician office experience Experience with EPIC and Echo/One App system applications preferred Two years related work experience in insurance credentialing and enrollment preferred.
Education
Associate degree in health care related field or 2 years equivalent experience in health care setting.
Specialized Knowledge and Skills
Excellent analytical and problem solving skills Knowledge of insurance enrollment systems including PECOS, WebDENIS, CHAMPS, CAQH. Microsoft Office skills including Word, Excel required. Knowledge of reimbursement process preferred
University of Michigan Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.
#LI-ML1
Administrative/Clerical
Requirements:
Shift
Days
Degree Type / Education Level
Associate
Status
Full-time
Facility
Sparrow Hospital
Experience Level
Under 4 Years