Sr. Provider Enrollment Research Representative (Remote)

TeamHealth is named among the ?150 Great Places to Work in Healthcare? by Becker?s Hospital Review and has ranked three years running as ?The World?s Most Admired Companies? by FORTUNE Magazine as well as one of America?s 100 Must Trustworthy Companies by Forbes Magazine in past years. TeamHealth, an established healthcare organizations is physician-led and patient-focused. We continue to grow across the U.S. from our Clinicians to our Corporate Employees and we want you to join us.
? Career Growth Opportunities
? Benefit Eligibility (Medical/Dental/Vision/Life) the first of the month following 30 days of employment
? 401K program (Discretionary matching funds available)
? GENEROUS Personal time off
? Eight Paid Holidays per year
? Quarterly incentive plans

This is a fully remote opportunity to support the Akron, OH Billing Center

JOB DESCRIPTION OVERVIEW:

The Sr. Provider Enrollment Research Representative reports to the Manager, Billing System Support/PER and is responsible for monitoring workflow trends and communicating to the Manager, Billing System Support/PER. The Provider Enrollment Research Senior is a resource for their assigned team and is responsible for training, escalation views in ETM (Enterprise Task Manager) and auditing of staff?s quality and production goals.

ESSENTIAL DUTIES AND RESPONSIBILITIES: ? Review Rejection PIT (Point in Time) Report for Open and Pended invoices for problematic areas. ? Review Rejection Outcome Report to Verify Invoices are worked properly. ? Review Provider hold Reports. ? Work and maintain ETM (Enterprise Task Manager) escalation view ? Assist assigned team as needed to reach Monthly Metrics and Goals. ? For each assigned team member review work performed, prepare QA reports and communicate to each team member. ? Responsible for training new employees and monitoring new employee production and QA. Reporting any concerns to the Manager, Billing System Support/PER. ? Review carrier manuals and websites and informs management of any new procedures implemented by the carrier that are impacting claims. ? Process Non-Routine Write-off adjustments as needed. ? Ensures appeals and provider related issues are followed up on timely for resolve. ? Communicate with the Manager, Billing System Support/PER on the progress of projects and assignments and progress toward completion on a timely basis. ? Other duties as assigned by the Manager, Billing System Support/PER.

Job Requirements:

QUALIFICATIONS / EXPERIENCE:
? Thorough knowledge of the revenue cycle
? Thorough knowledge of healthcare reimbursement guidelines
? Computer literate, intermediate Excel skill level
? Able to work in a fast-paced environment
? Good organizational and analytical skills
? Good oral and written communication skills
? Ability to work independently
? Ability to lead assigned team
? High school diploma or equivalent
? Minimum 3 years? previous medical billing experience required with emphasis on research and claim denials

SUPERVISORY RESPONSIBILITIES: ? Provides departmental leadership through training, quality audits, and development ? Assists Manager, Billing System Support/PER to ensure that Analysts are performing assigned duties and adhering to billing center/departmental policies, procedures and Code of Conduct.

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Job Snapshot

Employee Type
Full-Time

Location
Akron, OH (Remote)

Job Type
Health Care, Insurance

Experience
Not Specified

Date Posted
12/17/2024

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