Provider Enrollment Representative

Experience these exceptional benefits when you join Med-Metrix!

• 8-Hour Shifts, Fixed Weekends Off
• Day 1 HMO with 2 of your dependents covered for FREE
• Group Life Insurance
• Medical Cash Allowance
• Rice Allowance
• Clothing Allowance
• Holiday Gift
• Bereavement Assistance
• Free Lunch Daily
• Paid Time Off
• Training and Staff Development
• Employee Engagement Activities
• Opportunities for Internal Mobility
  
  

• Communicates with providers to explain process and sign applications
• Collects, updates, maintains necessary provider information and documentation and verifies the information where possible
• Establishes and maintains data entry in CAQH
• Prepares provider enrollment applications for all initial applications and re-credentialing in a timely and complete manner
• Verifies provider and group information with insurance companies (addresses, contracted plans, provider ID numbers, etc.)
• Coordinates information for enrollment and termination of all providers
• Handles enrollment with Medicare, Medicaid, commercial insurances
• Contributes to the departmental process and procedures with a collaborative approach
• Works department client WQ’s and smart feeds where applicable
• Maintains provider enrollment mailbox and completes actions and follow up
• Performs other duties as requested
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
• Understand and comply with Information Security and HIPAA policies and procedures at all times
• Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
  
  

• High School graduate or equivalent required
• Minimum two years of provider enrollment experience
• Knowledge of Microsoft Office Suite, Outlook, Excel, CAQH
• Billing knowledge and experience preferred
• Excellent verbal and written communication skills
• Strong interpersonal skills, ability to communicate well at all levels of the organization
• Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
• High level of integrity and dependability with a strong sense of urgency and results oriented 
• Excellent written and verbal communication skills required
• Gracious and welcoming personality for customer service interaction
  
  

• Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.
• Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
• Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
• Work Environment: The noise level in the work environment is usually minimal.