[Remote] Provider Enrollment Specialist at EnableComp

United States

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Revenue Cycle ManagementIndustries

Requirements

High School Diploma or GED required. Associates or Bachelor’s Degree preferred
1+ years’ experience in healthcare field working in billing or collections
1+ years’ client facing/customer services experience
Intermediate level understanding of insurance payer/provider claims processing and subsequent data requirements
Thorough understanding of the enrollment requirements and documents needed for the accurate completion of applications
Knowledge of general credentials and licenses is preferred but not required: hospital license, CLIA, DEA, NPI, board certifications, etc
Equivalent combination of education and experience will be considered
Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook)
Regular and predictable attendance
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions

Responsibilities

Collect, verify, and submit information necessary for the enrollment of hospitals/physicians with Out-of-State Medicaid payers
Develop and maintain ongoing policy and procedures specific to each state for new hospital/physician enrollments
Maintain working knowledge of hospital/physician Out-of-State Medicaid enrollment requirements and regulations
Ensure appropriate education and communication is shared with internal team members, including the Vice President and Senior Vice President of Operations
Submit re-enrollment applications in a timely manner to ensure hospitals/physicians are up to date with their enrollment status
Establish, maintain, and constantly review the accuracy of Out-of-State Medicaid requirements to ensure compliance with government rules and regulations
Manage work queue to ensure all timely submissions/deadlines of all payor-specific forms and documents to the various health plans including license updates, deficiency notifications, approval letters, etc
All maintenance of the provider file and communication of provider changes, corrections, and terminations documented in the database
Oversight and maintenance of the professional and facility enrollment process, including submission of both online and paper applications
Handling patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information

Skills

Key technologies and capabilities for this role

Provider EnrollmentMedicaid EnrollmentPHI HandlingHIPAA ComplianceApplication SubmissionPolicy DevelopmentHealthcare EnrollmentRevenue Cycle Management

Questions & Answers

Common questions about this position

What is the employment type for this position?

This is a full-time position.

What education is required for the Provider Enrollment Specialist role?

A High School Diploma or GED is required, with an Associates or Bachelor’s Degree preferred.

What are the main responsibilities of this role?

The role involves collecting, verifying, and submitting enrollment information for hospitals/physicians with Out-of-State Medicaid payers, maintaining policies and procedures, submitting re-enrollments, ensuring compliance, managing work queues, and maintaining provider files.

What is the company culture like at EnableComp?

EnableComp is a multi-year recipient of the Top Workplaces award, recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024, and is among the top one percent of companies on the Inc. 5000 list of fastest-growing private companies for the last eleven years.

What salary or compensation does this position offer?

This information is not specified in the job description.

EnableComp

Maximizes revenue from workers' compensation claims

About EnableComp

EnableComp focuses on helping healthcare providers maximize revenue from complex workers' compensation claims, which are often difficult to manage. The company simplifies this process by using a combination of clinical expertise, data analytics, managed care, and proprietary technology. Their main product, Enforcer, is a software that streamlines the management of these claims, allowing healthcare providers to concentrate on their core operations while EnableComp handles the billing and collections. Unlike competitors, EnableComp operates on an outsourcing model, taking over the claims management process for healthcare providers, which saves them time and resources. The goal of EnableComp is to ensure that their clients receive the highest possible reimbursement from workers' compensation claims.

Franklin, TexasHeadquarters

2000Year Founded

$5.3MTotal Funding

MERGERCompany Stage

Data & Analytics, Consulting, HealthcareIndustries

201-500Employees

Benefits

Flexible Work Hours

Professional Development Budget

Unlimited Paid Time Off

Risks

Emerging RCM technology companies may erode EnableComp's market share with competitive solutions.

Labor shortages in healthcare could impact EnableComp's service delivery and client satisfaction.

Frank Forte's appointment as CEO may lead to strategic shifts, risking client retention.

Differentiation

EnableComp specializes in complex workers' compensation claims management for healthcare providers.

Their proprietary software, Enforcer, enhances efficiency in claims processing and collections.

EnableComp's outsourcing model allows healthcare providers to focus on core operations.

Upsides

Increased AI adoption enhances EnableComp's claims processing and denial management efficiency.

RPA integration in billing offers automation opportunities, improving accuracy for EnableComp.

Healthcare providers' outsourcing trend aligns with EnableComp's business model, boosting partnerships.

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