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MS
Medix Staffing Solutions
Provider Enrollment Specialist
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Based on Illinois data
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What they do
An Enrollment Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. Assists eligible applicants with enrolling in a program.
$50,152 / year median in Illinois
+8% projected growth
Job Description
You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients. Job Summary Our client is seeking a Provider Enrollment Specialist responsible for overseeing payer enrollment and credentialing-related claim denials, supporting revenue cycle functions, and ensuring smooth provider enrollments in alignment with executed payer agreements. Key Responsibilities Serve as the subject matter expert for payer enrollment and credentialing-related claim denials. Review and work enrollment-related denials from Revenue Cycle teams to identify root causes and implement corrective actions. Research payer denials involving provider participation, effective dates, credentialing status, taxonomy, billing group assignments, contracting discrepancies, or enrollment errors. Coordinate timely claim corrections and resubmissions after enrollment issues have been resolved. Collaborate with the Contracting team to ensure provider enrollments align with executed payer agreements and contract effective dates. Assist in coordinating payer implementations for newly executed contracts and acquisitions. Qualifications Minimum 2 years of provider enrollment experience. Minimum 2 years of Revenue Cycle Management (RCM), billing, accounts receivable, or payer denial resolution experience. Strong understanding of Medicare, Medicaid, and commercial payer enrollment requirements. Experience working with provider enrollment systems, payer portals, and credentialing software. Skills Proficiency with CAQH ProView, PECOS, NPPES, and payer-specific enrollment systems. Working knowledge of provider contracting and payer implementation processes. Hours Per Week 40 hours per week Additional Requirements Standard work schedule is Monday to Friday, from 8:30am to 5:00pm. Benefits Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances). Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)). 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1). Short Term Disability Insurance. Term Life Insurance Plan. Required Employment / Compliance Language • We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).