# Provider Enrollment Specialist



## crittercoder (Nov 16, 2010)

Medical Management Specialists, a growing physician-owned-and-managed medical billing company which specializes in Emergency, Anesthesia, Urgent Care and Gastrointestinal Medicine coding and billing. Currently have full time openings at the Grand Rapids location, this is not a remote position.

Provider Enrollment Specialist
REPORTS TO:
Director of Coding

POSITION SUMMARY:
The Provider Enrollment Specialist administers the physician and PA enrollment and credentialing applications process. The Provider Enrollment Specialist is responsible for preparing and submitting credentialing applications and supporting documentation for the purpose of enrolling individual physicians and physician groups with payers. In this role, you will ensure the set up of the clients for electronic claims submission and electronic remittance advice. You will follow up on the status of applications for physicians and payers, and track the progress on all pending applications. 

PRINCIPAL DUTIES AND RESPONSIBILITIES:
• Implements the physician enrollment and credentialing process for clients who request provider enrollment services. Maintain the timelines on enrollment/credentialing schedules, communicate with providers and other departments to update as needed, clarify carrier information requirements, and maintain a strict level of confidentiality for all matters pertaining to provider credentials.
• Reviews new client packet information to determine any enrollment issues.
• Coordinates credentialing data needed for enrollment, contracting, and other related purposes. Credentialing data includes but is not limited to the medical degree, Drug Enforcement Administration (DEA) number, state license number, Board certifications, CV, malpractice insurance and state insurance form.
• Works closely with Physicians to obtain missing documentation for providers pertaining to provider enrollment. Obtains required client signatures and follows up with the carriers on documentation submitted.
• Maintains provider information and demographics for all providers.
• Responds to internal and external inquiries on routine enrollment and contract matters.
• Monitors and advises clients on license expirations.

OTHER DUTIES & RESPONSIBILITIES: 
• Performs other duties as requested by CEO and/or management.

KNOWLEDGE, SKILLS & ABILITIES:
• Bachelor's Degree from major college or university preferred.
• Minimum of 1 year experience in larger or similar-sized company required. 
• Knowledge of medical insurance carrier policies and procedures, and State and Federal rules and regulations. 
• Medicare, Medicaid, and Commercial Payer Provider Enrollment knowledge. 
• Knowledge of medical insurance carrier policies and procedures, and State and Federal rules and regulations. 
• Proficiency in Microsoft Office, particularly Excel and Word.
• Professional written and verbal communication and interpersonal skills required. 
• Ability to motivate teams, participate and facilitate group meetings required.
• Ability to effectively communicate with team members, supervisors, client staff and insurance contacts.
• Ability to maintain complete confidentiality in handling sensitive enrollment issues.
• Ability to work in a typical office environment involving sitting or standing for long periods of time, some light lifting, computer and desk work required

Medical Management Specialists offers a competitive salary and exceptional benefits package. 

Direct Contact Information:
Interested candidates should send a resume to: 
Attn: Director of Coding
4100 Embassy Dr. SE
Kentwood, MI 49546
Or fax: 616-988-8231


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