Enrollment & Billing Representative jobs in Maryland
Enrollment & Billing Representative is responsible for the accurate enrollment and billing process for an insurance organization. Maintains related documents, updates corresponding records and responsible for enrollment and billing query. Being an Enrollment & Billing Representative requires a high school diploma or its equivalent. Typically reports to a supervisor or manager. The Enrollment & Billing Representative possesses a moderate understanding of general aspects of the job. Works under the close direction of senior personnel in the functional area. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)
Recently Added Enrollment & Billing Representative jobs
Provider Enrollment Representative
- Children's National Hospital
-
Silver Spring, MD
FULL_TIME
-
The Provider Enrollment Representative will facilitate activities from the point of the provider candidate's acceptance of employment to the point of the candidate's approved enrollment with DC, Maryland, Virginia and West Virginia Medicaid and Medicare. The purpose of this position is to provide an efficient process to ensure that our new providers are enrolled prior to activation of privileges. The representative will work in concert with Medical Staff Services, the individual providers, department administrators and leadership to complete the enrollment applications and submit with all related credentials, licensing and other payer specific requirements. The Provider Enrollment Representative is a critical member of the Revenue Cycle and CNH organization teams for ensuring that providers are enrolled and prepared to begin working by the time of Board approval.
Minimum Education
High School Diploma or GED (Required)
Associate's Degree (Preferred)
Minimum Work Experience
3 years Experience in customer service in a healthcare setting, professional billing or denial resolutions based on in-network and provider enrollment requirements
(Required) Or
3 years Experience in provider medical licensing and State and Federal enrollment processes and applications. (Preferred)
Required Skills/Knowledge
Superior ability to interface effectively with providers, provider leadership, internal departments and external agencies.
Superior administrative skills to include strong organizational skills and the ability to multi-task.
Extreme attention to detail and ability to focus and perform without supervision.
Superior communication skills both written and oral.
Internet and computer skills to include intermediate Excel and Word
Knowledge of healthcare and professional provider services
Functional Accountabilities
Documenting accepted and eligible provider- Partner with Medical Staff Services to ensure capture of the new onboarding providers and identify those that are eligible for enrollment.
- Partner with Medical Staff Services to ensure that the CNH credentialing system is open for documenting enrollment activity and provider status
- Create and maintain accurate and detailed Excel rosters with required data to share, record, track and follow-up for enrollment activity
- Create and maintain archive files for storage and audit.
- Research for and coordinate licensure activities with MSS and the provider for the three jurisdictions for licenses, controlled substance certificates and DEA registrations and internally for the certificate of insurance.
- Follow-up for missing or delayed credentials and license documents within the defined timelines.
- Follow defined process and timelines escalating problems to the provider, department administrator and leadership for problems that will prohibit enrollment applications from filing within the expected time frames.
- Following defined payer guidelines create individual provider accounts with state and federal payers.
- Following defined payer guidelines complete online applications for DC, Maryland, Virginia and West Virginia Medicaid and within the required time frame.
- Following defined CMS guidelines complete PECOS and/or online application for Medicare and within the required time frame.
- Coordinate the required supporting documents with the application as defined by state and federal requirements.
- Document and track submission of the application to ensure receipt by the payer
- Working with the provider research and resolve license, data or NPPES registry problems related to denied or rejected applications within the required time frame.
- Team with Business Operations, Medical Staff Services, Managed Care, the individual provider and department leadership to communicate enrollment activity and related problems and work together to resolve while providing superior customer service and communication.
- Exhibit superior customer service and communications to providers, division chiefs and management
- Partner with insurance companies to problem solve application or system related problems.
- Participate in projects related to payer changes and annual maintenance of provider enrollments new and established.
- Participate in projects related to resolving established provider enrollment problems
Organizational Accountabilities (Staff)
Organizational Commitment/Identification- Anticipate and responds to customer needs; follows up until needs are met
- Demonstrate collaborative and respectful behavior
- Partner with all team members to achieve goals
- Receptive to others’ ideas and opinions
- Contribute to a positive work environment
- Demonstrate flexibility and willingness to change
- Identify opportunities to improve clinical and administrative processes
- Make appropriate decisions, using sound judgment
- Use resources efficiently
- Search for less costly ways of doing things
- Speak up when team members appear to exhibit unsafe behavior or performance
- Continuously validate and verify information needed for decision making or documentation
- Stop in the face of uncertainty and takes time to resolve the situation
- Demonstrate accurate, clear and timely verbal and written communication
- Actively promote safety for patients, families, visitors and co-workers
- Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance
Maryland-Silver Spring
Work Locations
Tech Hill
Job
Administrative Support / Customer Service
Organization
Finance
Position Status
R (Regular)
Shift
Day
Work Schedule
Monday - Friday 9:00a - 5:30p
Job Posting
Jan 25, 2024, 9:03:48 PM - 6 Days Ago
Billing Representative
- Robert Half
-
Baltimore, MD
FULL_TIME
- We are looking for a skilled Billing Clerk to join our client's team. Based in Baltimore, Maryland, this role offers a contract to hire employment opportunity. As a Billing Clerk, you will be responsi...
- 10 Days Ago
Billing representative
- Steps
-
Pikesville, MD
FULL_TIME
- STEPS Behavioral Health is an Applied Behavior Analysis (ABA) therapy company comprised of Board-Certified Behavior Analysts (BCBAs), Behavior Technicians, and a strong administrative team who work to...
- 25 Days Ago
Medical billing coding
- My Medical Billing Career
-
Halethorpe, MD
FULL_TIME
- Interested in a career in the Medical Billing & Coding field? My Medical Career can help! START TRAINING FOR YOUR NEW MEDICAL CAREER TODAY! Graduate employment services may be available once training ...
- 1 Month Ago
Medical billing coding
- My Medical Billing Career
-
Silver Spring, MD
FULL_TIME
- Interested in a career in the Medical Billing & Coding field? My Medical Career can help! START TRAINING FOR YOUR NEW MEDICAL CAREER TODAY! Graduate employment services may be available once training ...
- 20 Days Ago
Medical billing coding
- My Medical Billing Career
-
Beltsville, MD
FULL_TIME
- Interested in a career in the Medical Billing & Coding field? My Medical Career can help! START TRAINING FOR YOUR NEW MEDICAL CAREER TODAY! Graduate employment services may be available once training ...
- 20 Days Ago
Enrollment & Billing Representative jobs at Popular Companies
Billing Rep I
- Dignity Health
-
Rancho Cordova, CA
- Under the supervision of the A/ R Supervisor, the A/ R Billing Rep I is responsible for providing timely and efficient f...
- 6/11/2024 12:00:00 AM
Billing Rep
- Baptist Health
-
Little Rock, AR
- Shift: Day Working Hours: 40 hours per week Summary: First level position for Billing Rep. Performs all functions necess...
- 6/10/2024 12:00:00 AM
Biller/billing Rep
- Universal Health Services
-
Las Vegas, NV
- Responsibilities Western Region CBO The Western Region Consolidated Business Office provides business office services in...
- 6/9/2024 12:00:00 AM
Enrollment/Billing Representative - Remote
- Cigna Corporation
-
Warrendale, PA
- Follows standard operating procedures to edit, bill, and collect payment on basic outstanding claims in pursuit of reduc...
- 6/8/2024 12:00:00 AM
Enrollment & Billing Representative - HYBRID
- Cigna
-
Whitestown, IN
- This is a Hybrid role that will require on-site presence Working Hours: 8:00am - 4:30pm POSITION SUMMARY Utilizes advanc...
- 6/7/2024 12:00:00 AM
Billing Rep
- CHI Mercy Health
-
Omaha, NE
- We cannot thank our Billing Reps enough for the work they do! They are the ones that ensure charges are being processed ...
- 6/7/2024 12:00:00 AM
Billing Rep
- Catholic Health Initiatives
-
Pasadena, TX
- **Overview** CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. Wi...
- 6/7/2024 12:00:00 AM
Medical Billing Representative
- NTT DATA
-
Scottsdale, AZ
- Accounts Receivable or Medical Billing *Medicare Onsite Hours: 7am - 4pm AZ Position Summary: The Hospice/ESRD Billing R...
- 5/24/2024 12:00:00 AM
About Maryland
Maryland (US: /ˈmɛrələnd/ (listen) MERR-əl-ənd) is a state in the Mid-Atlantic region of the United States, bordering Virginia, West Virginia, and the District of Columbia to its south and west; Pennsylvania to its north; and Delaware to its east. The state's largest city is Baltimore, and its capital is Annapolis. Among its occasional nicknames are Old Line State, the Free State, and the Chesapeake Bay State. It is named after the English queen Henrietta Maria, known in England as Queen Mary.
Sixteen of Maryland's twenty-three counties border the tidal waters of the Chesapeake Bay estuary and...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Enrollment & Billing Representative jobs
$35,317 to $44,890
Most Popular Cities in Maryland for Enrollment & Billing Representative Jobs
What does an Enrollment & Billing Representative do?
Enrollment & Billing Representative in Boca Raton, FL
Showing up in person often demonstrates determination and initiative that most employers will find alluring in a potential representative.
February 13, 2020