Provider Enrollment Specialist- Temp to permanent

**9159260** **Provider Enrollment Specialist, Irving, TX, 3 months Contract** Sigma. Inc is currently looking for a Provider Enrollment Specialist to work onsite with our team located in Irving, TX. **Shift timings:** Monday - Friday, 8 am - 5 pm, 40 hrs/week **Summary** - Coordinates Medicare and Medicaid enrollment/re-enrollment and managed care credentialing and contracting processes for providers. - Serves as administrator for billing system and assists practices with system issues. - Maintains NPI files and provider numbers. - Serves as customer service liaison. - Monitors accounts receivable to maintain appropriate levels and reviews payments to maximize reimbursement. - Interacts with patients, insurance carriers, the billing vendor and practice personnel concerning patient accounts. - Performs all functions in a courteous and professional manner **Responsibilities** - Collects and maintains data on providers for Medicare and Medicaid enrollment - Prepares and submits applications to Medicare and Medicaid for new provider enrollments and existing provider updates; follows up by telephone or in writing, with carriers regarding application status - Complies with Medicare and Medicaid provider enrollment guidelines - Requests NPI numbers for providers and clinics as necessary and maintains NPI files - Follows up, either by telephone or in writing, with insurance companies and patients regarding the processing of outstanding claims and/or appeals - Generates various reports to identify outstanding claims issues with provider numbers and non-payment - Communicates information to appropriate personnel - Educates staff on corrections, e.g.. front-end entry errors in a positive, constructive manner - Collects and reviews managed care contracts for correct billing and payment terms - Identifies problem accounts and follows through to completion Reviews Athena correspondence and unpostables. - Participates in company sponsored enrollment/credentialing meetings and other educational activities - Participates in Billing System Training exercises and updates - Assists in training on the Billing System software package when necessary - Serves as a Superuser of the Billing System to be available to answer questions from the various clinics - Follows the clients guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI) - Maintains strict confidentiality - Uses oral and written communication skills to effectively convey ideas in a clear, positive manner that is consistent with the Clients Mission - Maintains established clients policies, procedures, objectives, quality assurance, safety, environmental and infection control - Implements job responsibilities in a manner that is consistent with the clients Mission and Code of Ethics and supportive of clients Physician Group's cultural diversity objectives - Performs other related work as required Other Information **Education/Skills** - High School Diploma or equivalent - 1-3 years of Payer Enrollment experience - Solid knowledge and utilization of PC applications to include WORD, EXCEL, ACCESS - Excellent written and verbal communication skills - Excellent organization and planning skills with demonstrated teamwork skills - Proven ability to interact with all levels of management and other Associates