Provider Enrollment Specialist

At Arietis Health, we recognize the vital role healthcare revenue cycle plays in maintaining the well‑being of individuals and businesses alike.

Our commitment is to demystify healthcare billing by empowering individuals and collaborating with premier healthcare organizations to address their executives' most pressing revenue cycle challenges. By doing so, we enable them to shift their focus towards providing exceptional patient care. Grounded in the belief of harnessing the expertise of a highly skilled team and advanced technology, we strive to cultivate a seamless patient billing experience that not only excels in efficiency but also delivers superior results.

Join us in achieving our mission. We’re actively seeking a Provider Enrollment Specialist to join our fast-growing team. This is an onsite position, located in our North Carolina office. If you're eager to contribute to redefining the landscape of healthcare revenue cycle management and be a part of our collaborative, positive, and human‑centric culture, we’d love to hear from you!

The
Provider Enrollment Specialist is responsible for processing enrollments for new and existing individual providers and group practices, such as initiating new enrollments with Commercial and Governmental payors and reporting demographic or other provider changes. Other duties include open applications with providers or payors, follow-up on old applications, applications that are rejected, applications where we are granted enrollment and claims are still rejecting, including escalation to the Provider Enrollment Manager and/or Vice President, Enrollment.

To excel in this role, an individual must satisfactorily perform the duties below; additional duties may be assigned. We are committed to intensive training opportunities and making reasonable accommodations to enable individuals with disabilities to perform the essential functions. Your contribution in this capacity is essential to our shared success.

• Ensure provider participation with contracted payors by taking appropriate next actions to complete enrollment, such as, completing applications, rosters, and notifications; monitor inventory
• Follow-up on Old Applications, Applications that are rejected, Applications where we are granted enrollment and claims are still rejecting.
• Escalate items to other areas outside of department, as needed
• Work with payors and providers to ensure compliance with enrollment process
• Initiate contact with payors and practices via telephone or electronic methods with respect to provider enrollment and billing errors, utilizing proper customer service protocol
• Update and maintain data in appropriate Provider Enrollment systems while ensuring accuracy and data integrity
• Review correspondence received then take appropriate action to resolve
• Appropriately resolve or escalate payor application denials
• Meet and maintain established departmental performance metrics for production and quality
• Maintain working knowledge of workflow, systems, and tools used in the department
• Perform other duties as assigned.
• Adherence to the Code of Conduct and Corporate Compliance Program

High school diploma, and minimum five years related experience and/or training in Medical Billing environment with an understanding of Healthcare Billing Processes; or equivalent combination of education and experience.

Minimum three (3) Years experience in Accounts Receivable and Provider Enrollment experience required.

Minimum three (3) Years related healthcare experience preferred, such as Medicare/Medicaid.

• Enrollment or Managed Care Enrollment
• Knowledge of National Plan and Provider Enumeration System (NPPES) and Council for Affordable Quality Healthcare (CAQH) preferred
• Proficient in Microsoft Office Suite or related software.
• Experience in working with reports, spreadsheets and Excel.
• Problem solving abilities.
• Excellent communication and customer relation skills.
• Ability to multi-task.
• Possess strong organizational skills.
• Understand HIPAA (Health Insurance Portability and Accountability) guidelines.
• Strong Language Ability:
  Read and interpret documents such as safety rules,…