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Payer Enrollment Specialist

*ETHOS LABORATORIES* – Newport, KY

LOCATION: This position is located in Newport, KY, two blocks from Newport on the Levee.

HOURS: Monday – Friday, 7:30AM – 3:30PM

POSITION SUMMARY:

The Payer Enrollment Specialist is responsible for preparing and submitting applications and supporting documentation for the purpose of enrolling Ethos Laboratories with payers in a timely manner. Interfaces with internal departments and external resources and organizations. Prepares and assists with reports for billing department. Maintains confidentiality as required.

EDUCATION AND EXPERIENCE REQUIREMENTS:

  • High School Diploma.
  • 2 or more years of payer enrollment/credentialing experience

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

  • Manage the completion and submission of applications to payers
  • Maintain documentation and reporting regarding enrollments in process
  • Retain records and documentation related to completed payer enrollments
  • Ensure re-enrollments with payers are completed timely
  • Respond to inquiries regarding status of applications received
  • Follow up with payers to monitor status of applications
  • Research and resolve application deficiencies
  • Send out applications, forms and other correspondence as requested
  • Ensure that established provider IDs and effective dates are communicated to Billing Manager and Billing Team Leads so claims can be processed for submission
  • Maintain a current and accurate data repository for enrollment information
  • Routinely communicate with Billing Manager on status of applications to payers
  • Research and resolve claim issues related to Ethos enrollment with payers to ensure appropriate revenue capture
  • Maintain payer website logins including billing staff access
  • Maintain payer contacts
  • Represent the office to internal and external customers as appropriate
  • Assist billing staff including but not limited to Appeals and Follow-up
  • Other duties/projects as assigned by management

REQUIRED SKILLS AND QUALIFICATIONS:

  • Regular and prompt attendance
  • Exceptional accuracy and attention to detail
  • Problem solving skills for identification of issues and the ability to develop appropriate courses of action
  • Excellent verbal and written communication
  • Effective organizational skills for prioritizing tasks to meet deadlines
  • Knowledge of all aspects of the revenue cycle
  • Proficient with Microsoft Outlook, Word, and Excel
  • Excellent phone etiquette
  • Ability to interact positively in a team environment
  • Follow all department and company policies and procedures