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Provider File Representative Senior

Company

Highmark Health

Location

Gulfport, United States

Type

Full time

Description

GENERAL OVERVIEW:
This position is responsible for corporate provider enrollment and provider file maintenance across all markets. This includes, enrollment, contracting and demographic provider information. Incumbent ensures compliance with BCBS and CMS requirements, DOH regulations, internal, private business and governmental audits. Responsible for reviewing and processing additions, updates, and deletions of provider information in the Provider File database. Ensures executions of data entry and updates are completed in a timely and accurate manner.


ESSENTIAL RESPONSIBILITIES

  • Maintain accurate data in provider file data systems. Common transactions include: Maintaining and initial setup of assignment accounts (AA) from the AA applicationsUpdating group and provider affiliations from AFBs and written requests 1099 tax ID updates UPIN/PTAN and/or Medicare Welcome Letter information State license update Enumera...
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