Overview
Provider Enrollment specialist Jobs in Visakhapatnam, Andhra Pradesh, India at Altaa Vistaa Business Solutions Pvt Ltd – AVPL
Role /Title :
Provider Enrollment Analyst
Job Description:
Shift  – 4.30
Pm to 1.30AM
Budget  – Upto 15
LPA
Experience  – 5+ Years
L3 & L4 experience , client facing roles.
Ideal candidate would be a team player with advanced Excel & CAQH experience, who is organized, detail-oriented, flexible,
transparent
, and self-driven.
Rosters / Payers:
Generate, audit, and submit over 100 rosters per month for insurance company and other payers throughout the country as needed
Submit all rosters to supervisor or manager for audit, while working toward an error rate of less than 10% and no longer requiring audits
Monitor submitted provider enrollment rosters to ensure they are processed and approved by payers, and communicate required approvals to our billing team prior to timely filing
Complete any provider demographic, payer validations, or audits requested within payers’ allotted time frames or contracted terms
Salesforce :
Develop understanding of how to tag, filter, build relationships, and remove items in Doc Gen Packages, within Salesforce, to assist the rest of the team by auto-populating required documents
Begin to learn how to build dashboards to assist the rest of the team with managing their workload
Other:
Manages daily administrative duties
Communicating data errors within our systems and notifying the applicable stakeholders
Prioritize requests and manage time and workload to execute project plans within given deadlines
Monitor fax, email inboxes, and SharePoint mail for the Provider Enrollment Analyst sub-team
Comfortable with working remotely full-time with the ability to adapt and work independently with little guidance
Client Relationships :
Responds timely to internal and external inquiries on any provider or contract matter including, but not limited to, routine follow up with payers on pending rosters and individual or practice location demographic inquiries
Serve as liaison between our billing company, providers, and payer representatives for a multitude of purposes
Maintain a strict level of confidentiality for all matters pertaining to provider credentials and information
Focus on tracking data integrity for the Provider Enrollment team and bring any concerns to their respective supervisor and manager
Co-Design with colleagues and payer contacts so that ad-hoc demands are completed efficiently and painlessly
Compliance:
Terminate inactive providers from insurance company, and other payer programs throughout the country to remain compliant with federal and state regulations
Maintain SB-137 and No Surprises Act rosters to remain compliant with federal and state regulations
Ensure data integrity across internal departments and payer systems through recurring validations
Participate in trainings and development to mitigate compliance risk with state and federal regulations
Begin to research determine resolutions to various payer issues with an overall goal to lose no more than $100K in revenue per year
Supports research, review, and testing of educational materials for organization growth
System Administration:
Ensure Salesforce reporting functions and settings are correctly operating team wide
Update re…
Title: Provider Enrollment specialist
Company: Altaa Vistaa Business Solutions Pvt Ltd – AVPL
Location: Visakhapatnam, Andhra Pradesh, India
Category: Healthcare, Administrative/Clerical
