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Coding - Enrollment Specialist

SOLD
Goodland, Kansas
Posted 5 years, 3 months ago
Expires in 0 minutes
204 Clicks

Description

The Provider Enrollment Specialist administers the physician enrollment application process for payer enrollment.  The Provider Enrollment Specialist is responsible for processing enrollments for new and existing individual providers, such as initiating new enrollments with Commercial and Governmental payors and reporting demographic or other provider changes. Other duties include follow-up on open applications with providers or payors.  Will work with credentialing specialist to ensure all aspects of enrollment are completed.

In addition to enrollment, the coding specialist, also known as a medical coder, documents patient data in code format for healthcare billing.  A coding specialist pulls specific details -- such as patient medical history, test results, diagnoses and treatment recommendations -- from physician notes, test reports, diagnosis forms and other related documents. Assigns codes and enters it into fields in computer applications, including electronic patient record management and billing software. Contacts sources of information to clarify information that is not clear or in error, and updates databases and forms as needed.  Will incode CPT and diagnosis coding for all facility and professional services.

POSITION QUALIFICATIONS:

Minimum Education:  High School diploma or equivalency required; Associates degree preferred. Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), Certified Coding Associate (CCA) or equivalent required.

Minimum Experience:   Three years healthcare experience preferred.  PECOS and CAQH knowledge required.  Knowledge of Medicare, Medicaid and commercial payer enrollment preferred.  Prior administrative office, customer service, or social service experience preferred.

Ability to speak, write, and read English fluently; ability to communicate clearly and effectively both orally and in writing. Excellent customer service and communication skills.  Organized and efficient; detail oriented.  Computer proficiency and experience with electronic health records.  Knowledge of Medicaid/Medicare and other third party insurance coverages.

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