Payer Enrollment Specialist
Tasks
- Collaborate with credentialing and billing teams
- Coordinate EDI connectivity with clearinghouses
- Ensure HIPAA compliant handling of provider data
- Escalate aging enrollments and connectivity issues
- Follow up with insurance payers
- Identify EDI process improvement opportunities
- Maintain enrollment documentation and records
- Monitor enrollment status and approvals
- Prepare EDI enrollment requests
- Resolve rejected and delayed EDI enrollments
- Submit EDI enrollment applications
- Support provider onboarding and client implementations
- Train team members on payer specific EDI workflows
- Validate NPI and TIN information
- Validate banking details
- Validate provider demographics and billing data
Perks/Benefits
- N/A
Skills/Tech-stack
Clearinghouse Coordination | Credentialing | Data interchange | EDI | EDI 270 | EDI 271 | EDI 276 | EDI 277 | EDI 835 | EDI 837 | Electronic Data | Electronic Data Interchange | Electronic Funds Transfer | Funds transfer | HIPAA | NPI | Payer portal | Process Improvement | Revenue Cycle | TIN | X12
Education
N/A
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