HYBRID: Enrollment Coordinator - Health Insurance

TEKsystems
$22.00 / hr
United States, North Carolina, Charlotte
Nov 16, 2024
As the Insurance Enrollment Coordinator If you're ready to explore the next step in your career: * * You'll enjoy... Career Opportunities - Tons of growth opportunities for your career Standard Hours - Hybrid role. Monday-Friday (8:00 AM - 6:00 PM) Competitive Pay - $22.00 an hour Expedited Interviews - Access to additional Resume support and pre-interview questions * * A day in the role... Applications: -Review task to submit applications timely. -Document all application components in Echo according to WF guidelines. -Submit applications within 2 days of task. -Submit accurate information to payers. -Resolve any payer correspondences and/or incomplete request by the payer deadline to prevent application withdrawal. -Utilize Epic to enter provider effective dates in Provider Enrollment Table to releasing of claims. -Validate group and provider loads by reading approval letters, making phone calls to payers, using web portals, and/or using completed files sent directly from payers. -Follow up timely on application submissions to track approvals and claims releases. -Work with assigned leader on any issues or challenges outside of workflows given. -Use effective and professional written and verbal communication. -Use proper escalation procedures. -Other duties will be assigned as needed and team member will float to other enrollment areas to assist. Claims: -Review rejection and denial transactions in Epic to start steps for resolution. -Make phone calls to payers to identify root cause reason for denial. -Utilize work guides and processes to determine if the provider is enrolled for the specified DOS. -Validate all enrollment components on 837P and perform thorough audit to determine reason for non-payment. -Perform appropriate functions in Epic to resolve claims. -Utilize Epic to enter provider effective dates in Provider Enrollment Table to releasing of claims. -Validate group and provider loads by making phone calls to payers, using web portals, and/or using completed files sent directly from payers. -Utilize systems and applications to locate the provider application submission date. -Value data in Epic daily for assigned providers and by WQ entry date. -Perform research on pending loads not entered by the payer over 60 days from app submission date. -Enter data in RCS Issue database as needed. -Work with assigned leader on any issues or challenges outside of workflows given. -Use effective and professional written and verbal communication. -Use proper escalation procedures. Necessary Skills and Strengths: Insurance \| Healthcare management \| Claims Follow Up \| Denied Claims \| Provider enrollment \| Credentialing \| Insurance Claim \| Claims adjudication Core Experience: * Experience with credentialing and enrollment is preferred * Strong experience with claims/insurance and understanding of enrollment process or implications * Strong experience with various payors * EPIC experience required * Microsoft Excel and Outlook required (Office in general) * Computer Savvy and ability to learn new systems * Intermediate Level About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.