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LogixHealth Senior Provider Enrollment Specialist in Bedford, Massachusetts

Are you interested in joining a team that strives to positively impact the healthcare system?

LogixHealth provides services and technology that result in smarter healthcare. We need the best and most inspired team members and are looking for people with a high level of intellectual curiosity and drive who always ask "why" and "how can we do it smarter."

If we have piqued your interest and you also possess:

  • A strong attention to detail and active listening skills

  • Proficient computer and Microsoft Excel skills

  • The ability to multitask

    We want to meet YOU!

    Purpose

    Perform all provider enrollment related procedures for physicians/mid/level providers to ensure groups can submit claims to insurance carriers for reimbursement.

    Duties and Responsibilities

  • Process provider enrollment applications for providers/groups

  • Research insurance provider enrollment requirements by state

  • Enter group/individual data to credentialing system

  • Prepare and submit provider enrollment applications with provider, insurance company or client sites

  • Interact with providers via phone or email as needed

  • Identify existing providers that are up for revalidation

  • Obtain information as requested by management

  • Update /Maintain Provider Enrollment Credentialing System

  • Collaborate with Billing Operations staff and Account Managers to resolve provider denials

  • Work with all team members to ensure tasks are completed

  • Attend conference calls with clients as needed following defined professional guidelines

  • Adhere to the Code of Conduct and be familiar with all compliance policies and procedures stored in LogixGarden relevant to this position

  • Uphold cooperative team environment by

  • Effectively communicating with management about provider and client issues

  • Following/adjusting procedures as necessary to create process efficiencies

  • Escalating issues to supervisor/manager

    Qualifications

    To perform this job successfully, an individual must be able to perform each duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities perform the duties.

    Education (Degrees, Certificates, Licenses, Etc.)

    High School Diploma or equivalent combination of education and experience required.

    Computer Skills

    Prior MS Office experience, including proficiency with Excel and Word, and internet software experience required.

    Experience

    One to two years related experience preferred.

    Specific Job Knowledge, Skill and Ability

  • Ability to add, to subtract, multiply and divide in all units of measure; this ability will encompass using whole numbers, common fractions and decimals

  • Ability to compute rates, ratios and percentages

  • Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedural manuals

  • Ability to write routine reports and correspondence

  • Ability to communicate effectively verbally and in writing

  • Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form

  • Ability to deal with problems involving several concrete variables in standardized situations

  • Specific vision abilities required by this job include close vision

  • Ability to work in a fast paced environment

  • Ability to participate in special projects while maintaining regular responsibilities

  • Ability to create tables or charts to display provider enrollment data

  • Ability to sit for prolonged periods of time, use hands, talk, hear and occasionally walk and reach with hands or arms

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