SUMMARY:

The Provider Enrollment Specialist, under the supervision of the Assistant Director of Patient Financial Services, performs a variety of duties related to provider payer enrollment; Accurately completes and submits enrollment applications; Responds to carrier enrollment, revalidations, update requests, advance disclosures of ownership(ADO) or any other enrollment related requests; maintains accurate tracking of the enrollment process; contacts carriers to expedite the enrollment process or to correct enrollment errors. Researches and resolves enrollment/ certification claim errors and preliminary/ EDI claim submission errors; Makes account adjustments and corrections as needed; Communicates effectively and professionally; Independently monitors workflow; project and clerical assistance as needed; Other duties as assigned

PREFERRED QUALIFICATIONS

Formal training which will probably be indicated by a high school diploma or equivalent, and a desired minimum of 2 years of health care provider enrollment experience, knowledge of medical coding; knowledge of third party fee profiles and reimbursement mechanism; knowledge of medical terminology and coding procedures; good typing skills and mathematical calculation ability; good verbal and written communication skills; good phone etiquette; Must have strong organizational skills and ability to work independently, be detail oriented, meet deadlines, and coordinate multiple projects simultaneously. Must be proficient with Microsoft Word and Excel. Knowledge of credentialing and health care claims software a plus. Must possess a valid Kentucky Driver s License.

PHYSICAL GUIDELINES

Physical guidelines include the ability to move, traverse, position self-remain in a stationary position and negotiate steps for up to eight hours per day; ability to lift up to 25 pound; use basic office equipment, to perform repetitive motions, and to stand/walk/sit for up to 10 hours per day. Must have visual and auditory acuity and be able to drive an automobile.

NOTE:

This document is intended to describe the general nature and level of work performed. It is not intended to act as an exhaustive list of all duties, skills, and responsibilities required of personnel so classified. Attendance is an essential function of the job.

LEXINGTON CLINIC IS AN EQUAL OPPORTUNITY EMPLOYER

(EOE)