Provider Enrollment Representative
Job ID: BH333108
Category: Customer Service
Job Title: Enrollment Processing Representative
Interview Process: Phone interview. Followed by in person interview
Hours (any flex on start/end times / any remote work?): 40
Job Location: Bedford (Need to be ok working in the office).
Dress: Business Casual
Co Size: 700+
Company Info/About: Healthcare industry client that is growing very quickly.
Why Open: Growth
- HS Diploma
- MS Office
- 1-2 years experience
Perform all provider enrollment related procedures for physicians/mid-level providers to ensure groups can submit claims to insurance carriers for reimbursement.
Duties and Responsibilities
- Process provider enrollment applications for providers/groups
- Research insurance provider enrollment requirements by state
- Enter group/individual data to credentialing system
- Prepare and submit provider enrollment applications to insurance carriers
- Follow-up on provider enrollment applications with provider, insurance company or client sites
- Interact with providers via phone or email as needed
- Collaborate with Account Managers to resolve provider denials
- Update/Maintain Provider Enrollment Credentialing System
- Attends conference calls with clients as requested
To perform this job successfully, an individual must be able to perform each duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities perform the duties.
Education (Degrees, Certificates, Licenses, Etc.)
High School Diploma or equivalent combination of education and experience required.
Prior MS Office experience, including proficiency with Excel and Word, and internet software experience required.
One to two years related experience preferred.
Specific Job Knowledge, Skill and Ability
- Ability to add, to subtract, multiply and divide in all units of measure; this ability will encompass using whole numbers, common fractions and decimals
- Ability to compute rates, ratios and percentages
- Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedural manuals
- Ability to write routine reports and correspondence
- Ability to communicate effectively verbally and in writing
- Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form
- Ability to deal with problems involving several concrete variables in standardized situations
- Specific vision abilities required by this job include close vision
- Ability to sit for prolonged periods of time, use hands, talk, hear and occasionally walk and reach with hands or arms
The Planet Group of Companies is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.