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Provider Enrollment Rep I - 300144

Employer
Noridian Healthcare Solutions
Location
Grand Forks, ND
Salary
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Industry
General
Role
Other
Job Type
Long-Term
Hours
Full Time
Job Summary

The Provider Enrollment Associate completes routine enrollment tasks in support of the provider enrollment representatives and team. This position researches and controls incoming applications and correspondence to ensure the work is properly categorized. This position reviews and processes a high volume of prospective Medicare provider enrollment applications.

Key Performance Indicators
  • Attention to detail and accuracy
  • Strong interpersonal communication skills
  • Organization, time management, and critical thinking skills


Essential Functions

Key Duties/Responsibilities/Accountabilities
  • Researches and controls incoming applications and correspondence to ensure work is properly categorized.
  • Enters data into internal document management and workflow systems.
  • Provides quality check on the provider enrollment data and enters application information into the claims processing systems (MCS, etc.).
  • Manages inbound/outbound online FAX queues to and from providers.
  • Quality assurance check claims processing system enrollment data.
  • Creates and mails notification letters.
  • Completes application returns and/or application acknowledgement process.
  • Supports other enrollment functions such as status calls, basic PECOS entry, special mailings, etc.
  • Reviews, researches, and processes provider enrollment applications abiding to contract regulations, internal policies, and guidelines.
  • Coaches providers through the enrollment process and provides inbound phone support.
  • Initiates requests for information to complete the online enrollment process.
  • Verifies credentialing information and completes fraud detection and prevention.

Non-Essential Duties and Functions
  • Supports team on special projects and assignments.
  • Other duties as assigned.
  • Special projects as assigned.

Requirements

Qualifications

Minimum Qualifications:
  • High school diploma or GED
  • 6 months' clerical or customer service experience
  • Computer skills, keyboarding, and data entry skills
  • Experience with computer programs such as Microsoft applications (Word, Excel, Access, Outlook), SharePoint, and Internet Explorer
  • Good computer keyboarding and data entry skills

Preferred Qualifications:
  • Knowledge of provider enrollment workload definitions, enrollment terminology, enrollment forms, and basic regulations, policies, and procedures
  • Proficient in Microsoft Application
  • Proficient in Microsoft Office applications


Environment and Cognitive/Physical Demands
  • Office Environment
  • Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve
  • Requires prolonged sitting and telephone usage
  • Requires the use of office equipment such as computer terminals, telephones, copiers and printers
  • Infrequent lifting up to 15 pounds
  • Infrequent stooping


Segregation of Duties

Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to, Segregation of Duties Principles, HIPAA Security and Privacy, CMS requirements, the Noridian Compliance Program, and any other applicable laws, rules and regulations.

Statement of Other Duties

This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions. Employees may be requested to perform job related tasks other than those specifically listed in this description, and may be required to perform any task requested by the supervisor or by management.

CMS Access Compliance and Regulation Contingency Statement

Some positions require compliance with (i) federal and agency-specific regulations and related clauses included in NHS's prime contracts with the Government, (ii) background checks, and (iii) eligibility for a government-issued identification card.

Other Information

Job Posting Policy 6.05

New employees with Noridian Healthcare Solutions will be eligible to apply for positions within their assigned department after successfully completing a 90-day review. For positions outside your department, you must attain a minimum of six months of service before you can apply.

Equal Employment Opportunity

Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individual with Disabilities, as well as Sexual Orientation or Gender Identity.

For questions, please email careers@noridian.com.

This job posting will be closed 12/31/2018 at 8:00AM CST. No further applications will be considered.



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