Description

Description The Provider Enrollment Analyst (I) is responsible for coordinating the provider enrollment and payer credentialing efforts for contracted FPA providers with Medicare and Medicaid. This individual manages all open provider enrollment tasks/ issues to ensure that providers are reimbursed for services provided and billed, and performs data analysis and special projects as assigned. Responsibilities 1. Enrolls and terminates providers with CMS and other government programs by completing 855 series forms, gathers credentials and associated documentation required for enrollment and process enrollment forms. 2. Tracks status of "in process" enrollment forms until final approval received. 3. Files provider ID numbers once assigned by governing agencies and performs system updates as appropriate. 4. Responsible for the initial setup of new groups and providers for 837P and 835P EDI transactions as well as EFT. 5. Monitors TES edits, BAR edits, eCommerce edits, and payer denials for issues related to enrollment, and follow-up on claims until resolved. 6. Participates in CBO rebilling ...