Provider Enrollment Customer Service Representative

Tasks

• Assess provider risk level and screening
• Assist providers with application packets in person and over the phone
• Compile documents for provider disciplinary action
• Conduct provider enrollment
• Determine provider eligibility using CMS guidelines
• Follow CMS audit process for compliance
• Interpret statutes rules policy manuals and clarifications
• Interview providers to elicit enrollment information
• Lead AMS team projects and presentations
• Perform provider site visits
• Research provider information in PECOS
• Train new staff and provide on the job mentorship
• Verify services office and equipment against application

Perks/Benefits

• Insurance benefits
• Paid Holidays
• Paid parental leave
• Paid sick time
• Paid vacation
• Public service loan forgiveness eligibility
• Public transit subsidy
• Remote work opportunities
• Retirement pension plan
• Rideshare subsidy

Skills/Tech-stack

CMS Compliance | Customer Service | Database Applications | Debt compliance | Eligibility determination | Email Applications | Interviewing | Medicaid | Medicare Debt Compliance | Microsoft Excel | Microsoft Word | PECOS | Provider enrollment | Research Methodology | Troubleshooting | Verbal communication | Written communication