Overview
Med-Metrix is seeking a Provider Enrollment Associate to manage credentialing and enrollment for new and existing healthcare providers. In this role, you will ensure accurate provider information, assist with applications, and maintain compliance with healthcare regulations. As a Provider Enrollment Associate, you will work closely with insurance companies, providers, and internal teams to streamline the enrollment process and support the organization’s mission of efficient healthcare management. This role is ideal for candidates with strong administrative skills, attention to detail, and experience in provider enrollment.
Key Responsibilities for Provider Enrollment Associate
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Communicate with healthcare providers to explain enrollment processes and obtain signed applications.
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Collect, update, and maintain provider documentation, verifying information where possible.
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Enter and maintain provider data in CAQH and other internal systems.
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Prepare and submit provider enrollment applications, including initial applications and re-credentialing.
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Verify provider and group information with insurance companies, including addresses, contracted plans, and provider ID numbers.
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Coordinate provider enrollment and termination processes with Medicare, Medicaid, and commercial insurers.
Administrative Support & Collaboration
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Manage the provider enrollment mailbox and complete follow-up actions.
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Contribute to departmental processes and procedures through a collaborative approach.
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Work departmental client WQs and smart feeds where applicable.
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Ensure all activities comply with HIPAA standards, protecting patient information at all times.
Qualifications & Skills
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High School diploma or equivalent required; additional education a plus.
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Minimum of 2 years of provider enrollment experience.
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Knowledge of Microsoft Word, Outlook, Excel, and CAQH.
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Billing knowledge and experience preferred.
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Excellent verbal and written communication skills.
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Ability to follow directions, collaborate with team members, and handle stress effectively.
Work Environment
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Occasional movement around the office; sitting, manual tasks, and operating office equipment required.
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Noise level typically minimal; ability to handle mental and physical demands of the role.
Equal Opportunity Employer
Med-Metrix is committed to diversity and will not discriminate based on race, color, religion, sex, gender identity, sexual orientation, age, disability, veteran status, or any other legally protected characteristic.