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SCA Provider Enrollment Representative I-Part A

Company: Anthem, Inc
Location: Cary
Posted on: June 12, 2021

Job Description:

Description

SHIFT: Day Job

SCHEDULE: Full-time

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.

This is an exceptional opportunity to do innovative work that means more to you and those we serve.

The SCA Provider Enrollment Representative I-Part A responsible for accurate and timely processing of Part A provider enrollment applications

Primary duties may include, but are not limited to:

+ Validates the accuracy of data submitted utilizing various electronic databases.

+ Ensures accurate entry of data into PECOS, CMS' national database for all certified Medicare providers and suppliers.

+ Processes initial, revalidation and change of information applications according to the IOM, including ensuring that the electronic funds transfers is active and current.

+ Calculates capitalization requirements for Home Health Agencies as required.

+ Reviews sales agreements and bill of sale for change of ownership agreements relating to change of information applications.

+ Reviews the agreement between CMS and the FQHC as well as the Health Resources and Services Administration grant for Federal Qualified Health Centers as required.

+ Based on the case file decision, forwards recommendations to CMS and state agencies for final enrollment determination as required.

+ Maintains an understanding of the CMS directives and follows all processes and procedures in order to maintain the integrity of the program.

+ May participate in special projects and/or completes reporting related to initial, revalidation and change of information applications.

+ Position may also assist with managing simple elevated provider inquiries with expedited contact to providers to address application issues impeding claims submissions.

+ Researches, reviews and completes reporting and analytics for internal and CMS reporting workload including ADHOC reports.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

Qualifications

PLEASE MONITOR YOUR EMAIL REGULARY FOR THE MODERNHIRE VIDEO INVITATION AND THE TYPING ASSESSMENT INVITATION

Training/Work Schedule:

Training: 5 week training class- Monday - Friday from 8:00am - 4:30pm

Work hours: Start as early as 7:00am; Monday - Friday, working an 8 hour shift

Location: This position may be located at one of the office locations below. Position is eligible to work from home. THE PAY FOR THIS POSITION IS NON-NEGOTIABLE:

+ 2400 Thea Drive, Harrisburg, PA 17110- $15.14 hourly (Harrisburg, PA)

+ 2415 S Austin Ave, Suite 104, Denison, TX 75020- $14.96 hourly (Denison, TX)

+ 8115-8125 Knue Road, Indianapolis, IN 46250- $14.91 hourly (Indianapolis, IN)

+ 75 SGT William B Terrace, Hingham, MA 02043- $16.58 hourly (Hingham, MA)

Qualifications

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

+ Associate's degree preferred. 1-3 years' experience in customer service or credentialing preferred.

+ Medicare Part A experience preferred.

+ Proficient computer skills in Microsoft Word, Excel and databases

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

+ Strong Data entry skills- 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

+ Candidate will be required to pass a typing test

Preferred Qualifications:

+ Experience in Provider Enrollment, Provider Relations, or Credentialing preferred.

+ 855 application processing knowledge- highly preferred

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

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

REQNUMBER: PS44940

Keywords: Anthem, Inc, Cary , SCA Provider Enrollment Representative I-Part A, Other , Cary, North Carolina

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