Job Details

SCA Provider Enrollment Representative I / Part B – Hingham, MA – 134835

Service Contract Act
MA-Hingham
December 6, 2017

Description

Your Talent. Our Vision. At National Government Services (NGS), an independent subsidiary of Anthem, Inc. and one of the largest Medicare contractors in the country, it’s a powerful combination. It’s the foundation upon which we’re creating greater access to care for our members, greater value for our customers and greater health for our communities. Join us and together we will drive the future of health care.

Provider Enrollment Representative

Responsible for reviewing and processing credentialing applications and supporting documentation for the purpose of enrolling individual physicians and physician groups with payers. Responsible for accurate and timely processing of Part B provider enrollment applications.

Primary duties may include, but are not limited to:

* Interact professionally with providers and staff representatives to provide information on any necessary documentation required for processing. Tracks and follows up with providers for timely return of all required objectives.

* Validates the data to be housed on provider databases and ensuring adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.

* Apply knowledge/skills to complex activities. Also assists in synchronization of data among multiple claims systems and application of business rules as they apply to each database.

* Demonstrate a depth and breadth of knowledge/skills in own area and is often able to apply these outside of own function

* Anticipate customer needs and proactively identify solutions

* Solve complex problems on own; proactively identify new solutions to problems

* Plan, prioritize, organize and complete work to meet established objectives and timeliness metrics

Qualifications

Location: Hingham, MA….on site only (not work from home)

Training: 5 week training class-Monday – Friday from 8:30am – 5:00pm

Work hours: Start as early as 7:00am working an 8 hour shift

Candidate will be required to pass a typing test.

Requirements:

* Requires a H.S. diploma; or any combination of education and experience, which would provide an equivalent background.

* 1-3 years’ experience in Provider Enrollment, Provider Relations, or Credentialing preferred.

* Intermediate computer skills in Microsoft Word, Excel and databases

* Capable of meeting time-sensitive deadlines and multi-tasking

* Strong Data entry skills

* At least 2 years of 855 application processing knowledge- highly preferred

* Knowledge of CMS (Center for Medicare/Medicaid Services) regulations and guidelines – highly preferred

* 1+ years of data entry experience

* Ability to work independently and remain on task

* Strong organization and planning skills

* Strong interpersonal and oral communication skills including professional telephone etiquette

* Intermediate level of research and analytical skills

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.

*WARNING : Please beware of phishing scams that promote work-at-home opportunities and which may also pose as legitimate companies. Please be advised that an Anthem recruiter will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for a role with our company. All of our careers require that you first complete an online application.