Provider Enrollment Specialist

The Provider Enrollment Specialist works in conjunction with the Provider Enrollment Manager to identify Provider Payer Enrollment issues or denials. This position is responsible for researching, resolving, and enrolling any payer issues, utilizing a variety of proprietary and external tools. This will require contacting clients, operations personnel, and Centers for Medicare & Medicaid Services (CMS) via phone, email, or website. Essential Functions and Tasks: Performs follow-up with market locations to research and resolve payer enrollment issues Performs follow-up with Centers for Medicare & Medicaid Services (CMS), and other payer via phone, email or website to resolve any Payer Enrollment issues Manages the completion and submission of CMS Medicare, State Medicaid and any other third-party payer applications Performs tracking and follow-up to ensure provider numbers are established and linked to the appropriate client group entity and proper software systems Maintains documentation and reporting regarding payer enrollments in process. Retains records related to completed CMS applications Establishes close working relationships with Clients, Operations, and Revenue Cycle Management team Proactively obtains, tracks, and manages all payer revalidation dates for all assigned groups/providers as well as complete, submit, and track the required applications to maintain active enrollment and prevent deactivation Maintains provider demographics in all applicable enrollment systems Adds providers to all applicable systems and maintains information to ensure claims are held/released based on status of enrollment Performs special projects and other duties as assigned