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Provider Enrollment Research Representative
Provider Enrollment Research RepresentativeUnited States
External Job Description and Responsibilities
Make an impact behind the scenes by helping ensure healthcare claims are processed accurately and efficiently. As a Provider Denials Representative, you'll play a key role in researching and resolving provider and claim-related issues that support timely reimbursement and operational success. What You'll Do In this role, you'll investigate provider and claim denials, identify root causes, and take the appropriate steps to help move claims through the billing process. You'll collaborate with teammates and leadership to resolve issues while maintaining high levels of accuracy and productivity in a fast-paced environment. Key Responsibilities- Review assigned denial worklists and research provider-related claim denials
- Analyze rejected claims and determine the appropriate resolution based on payer requirements
- Identify and report provider enrollment or termination issues according to established guidelines
- Escalate carrier-specific claim issues and provide supporting documentation as needed
- Review payer provider manuals for billing updates and communicate relevant changes
- Identify recurring claim processing errors and report trends to leadership
- Partner with the Accounts Receivable team to support departmental goals
- Seek guidance from senior team members or leadership on complex claim, fee schedule, or write-off situations
- Complete additional duties as assigned
Requirements
What Makes You Successful- Strong analytical and research skills with attention to detail
- Ability to prioritize work and maintain productivity in a high-volume environment
- Excellent organizational and problem-solving abilities
- Comfortable working independently while collaborating with a team
- Strong communication skills and commitment to accuracy
- 1+ year of medical billing experience with a focus on researching provider and/or claim-related issues
- Knowledge of physician billing policies and procedures
- Strong computer skills and proficiency navigating multiple systems
- High school diploma or equivalent
- Opportunities for career growth and professional development
- An inclusive culture where everyone feels valued, respected, and empowered to belong
- Comprehensive medical, dental, and vision coverage beginning the first of the month following 30 days of employment
- 401(k) plan with discretionary company match for eligible employees
- Generous paid time off to support work-life balance for eligible employees
- Eight paid company holidays each year
- Company-provided equipment for eligible remote positions
Location
RemoteWorking Level
Full-Time1+ year medical billing experience with focus on provider/claim research; knowledge of physician billing policies; strong computer skills; high school diploma or equivalent.
Key Responsibilities
- researching claim denials
- analyzing rejected claims
- reporting trends
Job Details
- Category: Healthcare Services - Allied Health
- Seniority: Entry Level
- Commitment: Full Time
- Workplace: Remote — United States
- Languages: English
Benefits
- 401k matching
- Generous paid time off
- Retirement plan
About TeamHealth
A leading physician practice in the U.S. providing patient care and healthcare revenue cycle operations. — Industry: Healthcare