Provider Enrollment Rep-711031

SUMMARY STATEMENT
This position is responsible for the integrity of the Medicare Part A and or B Provider files. This position will review applications and ensure compliance with CMS regulations and internal procedures and protocols.

 

 

ESSENTIAL RESPONSIBILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This list of essential job functions is not exhaustive and may be supplemented as necessary.

 

Process submitted provider applications: (90%)
* Obtain additional information via telephone or in writing.
* Research and validate information as needed to complete enrollment application.
* Determine if both state and federal regulatory requirements are met.
* Review supporting documentation for adequacy; make final determination/recommendation on application.
* Create enrollment records in applicable system(s).
* Make any updates in system as necessary.
* Establish Electronic Funds Transfer (EFT) of provider Medicare payments.
* Research and respond to application specific or general provider enrollment written inquiries.

 

Perform other supportive activities, attend Provider Enrollment and company sponsored meetings, and attend training sessions. (10%)

 

Performs other duties as the supervisor may, from time to time, deem necessary.

 

 

REQUIRED QUALIFICATIONS
* High school diploma or GED
* 1 year work experience in a customer service role and/or one year work experience in a position where the applicant has used a computer and Microsoft Office.
* Proficiency with PC's and in Windows based environments; including Microsoft Office (Word, Excel, Outlook)
* Effective written and verbal communication skills
* Demonstrated skills in reading comprehension
* Demonstrated problem solving and research skills
* Demonstrated attention to detail
* Strong organizational/time management and interpersonal skills

 

PREFERRED QUALIFICATIONS
* Provider enrollment experience
* Experience working in a production environment while achieving quality requirements

Background Investigation: If you are selected for this position, you must undergo a pre-employment Background Investigation, Drug Screen, and Identity Proofing documentation must be cleared prior to hire. Most positions are subject to additional Identity Proofing, Fingerprinting and additional Background Investigation screening conducted by the Federal Government to be granted Enterprise User Administration (EUA) system logical access after you begin your employment. Your continued employment is contingent upon the outcome of the complete additional screening criteria required for the position which must find that you meet the applicable government customer's requirements (e.g., suitable for access to CMS information and information systems), as well as any additional investigation which may be required throughout your employment. If you are found not suitable, your employment may be subject to corrective action, up to and including immediate termination of employment.

 

Identity Documentation: You must have access to a current and unrestricted REAL ID, U.S. Passport, U.S. Passport Card, Foreign Passport, or U.S. Permanent Residency Documents. Note: Employment Authorization Cards (EAD) are not a substitute for Visas or U.S. Permanent Resident Cards.