Can be Fully Remote or Hybrid

JOB OVERVIEW

Responsible for preparing and submitting payer enrollment applications and supporting documentation for the purpose of enrolling the laboratory with payers in a timely manner.

ESSENTIAL FUNCTIONS

• Manage the completion and submission of payer enrollment applications
• Maintain documentation and reporting regarding payer enrollments in process
• Retain records and documentation related to completed payer enrollment
• Ensures re-enrollment with payers are completed timely
• Respond to inquiries regarding status of applications received
• Follow up with payers to monitor status of applications
• Research and resolve enrollment application deficiencies
• Send out payer applications, forms and other correspondence as requested
• Ensure that established payer IDs and effective dates are communicated to Billing Manager and Billing Team Leads so claims can be processed for submission
• Maintain a current and accurate data repository for enrollment information
• Routinely communicates with Billing Manager on status of enrollment applications
• Researches and resolves claim issues related to enrollment with payers to ensure appropriate revenue capture
• Maintain payer website logins including billing staff access
• Maintain payer contacts
• Represents the office to internal and external customers as appropriate
• Maintain strict confidentiality of information as dictated by current HIPAA requirements
• Assist billing staff including but not limited to Appeals, Follow-up, Payment posting, etc.
• Other duties as assigned

PROFESSIONAL REQUIREMENTS

• Regular and prompt attendance
• Problem solving skills for identification of issues and the ability to develop appropriate courses of action
• Excellent organizational skills for prioritizing tasks to meet deadlines
• Knowledge of all aspects of the revenue cycle
• Ability to interact positively in a team environment
• Follow all department and company policies and procedures
• Proficient with Microsoft Office applications

EDUCATION AND EXPERIENCE REQUIREMENTS

• High School Diploma
• 2 or more years of provider enrollment/credentialing experience

KNOWLEDGE, SKILLS AND ABILITIES

• Ability to communicate effectively, orally, and in writing
• Skill in data entry with minimal errors

PHYSICAL REQUIREMENTS

• Work in varying degrees of temperature (heated or air conditioned)
• Position requires sitting, walking, reaching, bending, stooping, and handling objects with hands and/or fingers, talking and/or hearing, and seeing

DIRECT REPORTS

• None