Provider Enrollment Research Representative

TeamHealth; United States; A distancia; USD 30.000 - 39.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

401(k) plan with discretionary company

Generous paid time off

Company-provided equipment for remote

Medical, dental, and vision coverage

Descripción de la vacante

TeamHealth in the United States is seeking a Provider Denials Representative to help ensure healthcare claims are processed accurately and efficiently. You will research provider and claim denials, identify root causes, and move claims through the billing process with accuracy in a fast-paced environment.

You'll review denial worklists, analyze rejected claims, and escalate issues with supporting documentation.

Formación

• 1+ year of medical billing experience focusing on provider/claim issues.
• Knowledge of physician billing policies and procedures.
• Ability to navigate multiple systems efficiently.
• Attention to detail and accuracy.

Responsabilidades

• Review denial worklists and research provider denials.
• Analyze rejected claims and determine resolutions.
• Identify enrollment/termination issues per guidelines.
• Escalate carrier-specific issues with documentation.
• Review payer manuals for billing updates.
• Identify recurring errors and report trends.
• Partner with Accounts Receivable to meet goals.
• Handle complex write-off situations with guidance.
• Complete additional duties as assigned.

Conocimientos

Analytical skills

Research skills

Detail oriented

Independent worker

Team collaboration

Educación

High school diploma or equivalent

Herramientas

Medical billing software

Descripción del empleo

United States

External Job Description and Responsibilities

Make an impact behind the scenes by helping ensure healthcare claims are processed accurately and efficiently. As a Provider Denials Representative, you'll play a key role in researching and resolving provider and claim-related issues that support timely reimbursement and operational success.

What You'll Do

In this role, you'll investigate provider and claim denials, identify root causes, and take the appropriate steps to help move claims through the billing process. You'll collaborate with teammates and leadership to resolve issues while maintaining high levels of accuracy and productivity in a fast-paced environment.

Key Responsibilities

• Review assigned denial worklists and research provider-related claim denials
• Analyze rejected claims and determine the appropriate resolution based on payer requirements
• Identify and report provider enrollment or termination issues according to established guidelines
• Escalate carrier-specific claim issues and provide supporting documentation as needed
• Review payer provider manuals for billing updates and communicate relevant changes
• Identify recurring claim processing errors and report trends to leadership
• Partner with the Accounts Receivable team to support departmental goals
• Seek guidance from senior team members or leadership on complex claim, fee schedule, or write-off situations
• Complete additional duties as assigned

Requirements

What Makes You Successful

• Strong analytical and research skills with attention to detail
• Ability to prioritize work and maintain productivity in a high-volume environment
• Excellent organizational and problem-solving abilities
• Comfortable working independently while collaborating with a team
• Strong communication skills and commitment to accuracy

You Bring

• 1+ year of medical billing experience with a focus on researching provider and/or claim-related issues
• Knowledge of physician billing policies and procedures
• Strong computer skills and proficiency navigating multiple systems
• High school diploma or equivalent

Why TeamHealth

At TeamHealth, you'll join a culture built around collaboration, innovation, and purpose. TeamHealth is proud to be the leading physician practice in the U.S. providing exceptional patient care, together.

TeamHealth has been recognized as one of the "165 Top Places to Work in Healthcare" for 2026 by Becker's Hospital Review. TeamHealth has also been recognized by Newsweek as one of America's Greatest Workplaces in Health Care for 2025.

We continue to grow across the U.S. from our clinicians to corporate employees.

What We Offer

• Opportunities for career growth and professional development
• An inclusive culture where everyone feels valued, respected, and empowered to belong
• Comprehensive medical, dental, and vision coverage beginning the first of the month following 30 days of employment
• 401(k) plan with discretionary company match for eligible employees
• Generous paid time off to support work-life balance for eligible employees
• Eight paid company holidays each year
• Company-provided equipment for eligible remote positions