Healthcare Provider Enrollment Specialist

Industry

Call Center and Customer Service

Advert ID

USA_586231

Location

Durham

Job Type

Contract

Hours

Full-Time

Salary Range

Based on Experience

No. of Openings

1

Branch Information

Raleigh - Durham NC Area - (USA) 430 Davis Drive Suite 100 NC Morrisville , NC 27560

ContactNumber

855-591-7454

Job Description

Manpower is now seeking a Provider Information Analyst to work with a national company in Durham, NC! Manpower offers great benefits and is excited to watch you grow in your career! Come work with a company that offers great benefits, pay, flexible scheduling and fun people to be around! Join a winning TEAM! Together we WIN!



Job Description:



* Accurately complete provider enrollment, terminations, demo changes and contracts in provider systems of record to ensure appropriate claims payment in accordance with contractual language.

* Compile, analyze, and verify the required information for provider enrollment, contracts, and maintenance for completeness and accuracy,

and enter it into the systems of record.

* Communicate, orally and in writing, directly with providers to resolve questions and issues regarding updates and changes in the systems

of record.

* Research, respond to, analyze and resolve complex claims issues related to provider setup and provider eligibility on a daily basis.

* Create resolution documents to address provider issues and increase provider satisfaction. Utilize probing and problem-solving methods to

resolve all inquiries/requests. Identify, understand and anticipate providers' unexpressed needs and concerns.

* Provide cross-functional support and serve as Subject Matter Experts (SMEs) or second-tier resolution to internal and external provider

teams (i.e., PSA team, Credentialing, Contracting, Provider Service Consultants, etc).

* Manage timely responses to external provider inquiries and requests. Evaluate new service requests from providers to determine

appropriate actions for recording into the systems of record.

* Perform gap analysis on requests and follows through with communication and/or education to providers on internal process and

issues.

*Identify system problems, gaps or inconsistencies in workflows and/or processes. Recommend appropriate updates, alternatives, and solutions.



Hiring Requirements:

* Associates/Bachelor's degree or certification in business or health-related field with a demonstration of strong analytical skills in business, systems or information management (can be through coursework, internships or relevant work experience).

* MS Office knowledge required

* Ability to adapt to changes quickly

* Is able to work in a high production environment

* Time Management and Strong Organization skills

* Team Mentality

* Must be very analytical, good to have provider data knowledge, previous extensive claim background, or a customer service background.

* Data entry is involved in this position BUT this is not a data entry position.



If you have not created a Manpower Profile please do so by going to www.manpower.com to create your profile prior to us contacting you! We look forward to working with you!