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Posted 07/20/2022
Job # 75317
Title: Medical Provider Enrollment & Billing Specialist
Facility: Prime Care Technologies
Company: Prime Care Technologies
Location: Duluth, GA
Salary: 50k - 55k

Do you have claims experience in long-term or post-acute care? Do you have medical billing experience that includes knowledge of X12, 837i and 837p file formats? If you said yes to these questions, we want to meet you. ProClaim Partners, LLC, an affiliated company of Prime Care Technologies, is currently recruiting for a Medical Enrollment & Billing Specialist for our primeCLAIMS software. Our software platform is a clearinghouse for Medicare and Medicaid claims within the skilled nursing community.


Updates and maintains Provider Enrollment Databases for new payer enrollment & payer credentialing
Accurately maintains internal system with appropriate provider and network participation information
Develops databases and spreadsheets for tracking organization providers
Performs business analysis
Serves as customer contact and ensures customer issues are resolved timely to ensure satisfaction
Provides customer support via remote methods and updates ticketing system
Assists customer in the resolution of provider enrollment issues
Facilitates state Medicaid renewals as needed
Performs QA and testing of primeCLAIMS products
Provides feedback to developers on enhancements
May perform front end system testing prior to product version releases
Operates under minimal supervision once training is complete
Maintains log of customer enhancement requests
Informs appropriate internal personnel of problems or concerns expressed by our customers
Work hours may include evenings to support our west coast customers and/or payers
Performs additional duties as necessary

• Bachelor’s degree in I.T. or Business preferred or equivalent work experience.
• 2 to 4 years of experience performing support tasks in a help desk role preferably in a large enterprise environment.
• Medical billing experience required, prefer both professional and Institutional including knowledge of X12, 837i and 837p file formats
• Payer enrollment experience with Medicare, Medicaid and/or Commercial insurance highly preferred
• Exceptional customer service skills with expertise in troubleshooting, diagnosing and solving complex claim related issues.
• Relevant and demonstrable technical support service experience in a software environment.
• Strong Knowledge of the field’s concepts, practices and procedures.
• Excellent organizational, time management, written and verbal communication skills
• Strong working knowledge of computer hardware and network operating systems.
• Proficient technical knowledge of MS-Windows operating system, MS Office suite, MS SQL Server, concepts of SQL databases
• The ability to work quickly and accurately in a shared community environment.
• Ability to complete multiple tasks with minimal direction.
• Advanced hardware and network connectivity trouble shooting skills.
• Advanced knowledge of MS Outlook and MS Exchange in a large enterprise environment.
• Ability to listen and analyze customer needs
• Ability to interact with end-users, Vendors, and Client IT departments.
• Experience in using common Customer Service software.
• Presents a positive image that reflects well on the organization.

Contact: Joy Miles, Human Resources Manager

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