Payer Enrollment Specialist
*ETHOS LABORATORIES* – Newport, KY
LOCATION: This position is located in Newport, KY, two blocks from Newport on the Levee.
HOURS: Monday – Friday, 7:30AM – 3:30PM
POSITION SUMMARY:
The Payer Enrollment Specialist is responsible for preparing and submitting applications and supporting documentation for the purpose of enrolling Ethos Laboratories with payers in a timely manner. Interfaces with internal departments and external resources and organizations. Prepares and assists with reports for billing department. Maintains confidentiality as required.
EDUCATION AND EXPERIENCE REQUIREMENTS:
- High School Diploma.
- 2 or more years of payer enrollment/credentialing experience
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
- Manage the completion and submission of applications to payers
- Maintain documentation and reporting regarding enrollments in process
- Retain records and documentation related to completed payer enrollments
- Ensure re-enrollments 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 application deficiencies
- Send out applications, forms and other correspondence as requested
- Ensure that established provider 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 communicate with Billing Manager on status of applications to payers
- Research and resolve claim issues related to Ethos enrollment with payers to ensure appropriate revenue capture
- Maintain payer website logins including billing staff access
- Maintain payer contacts
- Represent the office to internal and external customers as appropriate
- Assist billing staff including but not limited to Appeals and Follow-up
- Other duties/projects as assigned by management
REQUIRED SKILLS AND QUALIFICATIONS:
- Regular and prompt attendance
- Exceptional accuracy and attention to detail
- Problem solving skills for identification of issues and the ability to develop appropriate courses of action
- Excellent verbal and written communication
- Effective organizational skills for prioritizing tasks to meet deadlines
- Knowledge of all aspects of the revenue cycle
- Proficient with Microsoft Outlook, Word, and Excel
- Excellent phone etiquette
- Ability to interact positively in a team environment
- Follow all department and company policies and procedures