Provider Enrollment Specialist \ 1232

Provider Enrollment Specialist Job Summary The Provider Enrollment Specialist coordinates Medicare and Medicaid enrollment/re-enrollment, as well as managed care credentialing and contracting processes for healthcare providers. This role serves as the administrator for the billing system, assists practices with system issues, maintains NPI files and provider numbers, and acts as a customer service liaison. The specialist also monitors accounts receivable to maintain appropriate levels, reviews payments to maximize reimbursement, and interacts with patients, insurance carriers, billing vendors, and practice personnel regarding patient accounts. All functions are performed in a courteous and professional manner. Key Responsibilities Collect and maintain provider data for Medicare and Medicaid enrollment. Prepare and submit applications for new provider enrollments and updates; follow up with carriers regarding application status. Ensure compliance with Medicare and Medicaid provider enrollment guidelines. Request and maintain NPI numbers for providers and clinics. Follow up with insurance companies and patients regarding outstanding claims and appeals. Generate reports to identify issues with provider numbers and non-payment. Communicate relevant information to appropriate personnel. Educate staff on corrections (e.g., front-end entry errors) in a constructive manner. Collect and review managed care contracts for accurate billing and payment terms. Identify problem accounts and ensure resolution. Review Athena correspondence and address issues as needed. Required Qualifications High School Diploma (proof of education required). 1–3 years of experience in payer enrollment. Solid knowledge of PC applications, including Word, Excel, and Access. Preferred Qualifications (if any) Experience with healthcare billing systems (e.g., Athena). Prior exposure to managed care contracting and credentialing processes. Certifications (if any) None required; relevant certifications in healthcare administration or billing are a plus. Education: High School

Compunnel Inc., established in 1994; is a leading provider of Staffing, IT/Software, e-Learning/Training, Business Intelligence, and Cloud Solutions. A leader in contingent and permanent workforce solutions, we also provide temp-to-hire staffing, project-based/SOW staffing, and payroll services to our esteemed clientele which includes Fortune 500 companies of diverse industry segments. Ranked as one of the largest staffing firms in the US which is our primary service market; we also have a significant presence in Europe and Asia. As a national service provider in the US, we are serving our customers all major states and regions; thereby generating numerous job opportunities for prospective employees in their preferred locations of choice.

We have witnessed multi-fold YOY growth, and continuously adding a large pool of talented resources to our employee base every year. Our extensive experience in hiring professionals of multiple in-demand skill sets (IT, Engineering, Healthcare, Admin-Clerical, Finance, Professional, Light Industrial, etc.) further makes Compunnel a wider and preferred platform for people to pursue their careers in the US. We welcome people from all walks of life and cultures, and we support workforce diversity by providing equal employment opportunities to people without any discrimination based on race, color, gender, religion, national/ethnic region, disability, or any other basis.