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Provider Enrollment Coordinator

Remote:

Full Remote

Experience:

Mid-level (2-5 years)

Work from:

United States

Offer summary

Qualifications:

Associate's degree or equivalent experience, 3 years provider enrollment experience, Proficiency with Microsoft Office applications, Knowledge of credentialing procedures.

Key responsabilities:

Timely enrollment of providers with payers
Maintain provider data in systems

Talent Group Scaleup http://www.talentgroups.com

501 - 1000 Employees

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Job description

Duration: 3 months to start

Job Description

Under the supervision of the Associate Director of Medical Staff Office & Provider Enrollment, is responsible for the timely enrollment of all new and existing Medical Center and Medical Group practitioners with third party payers. Maintains provider data in existing computer software systems with accuracy and efficiency.

Requires an individual with strong organizational skills, detail oriented with an ability to work in varied and busy atmosphere and an individual who can independently organize and prioritize the workload to support the goals of the Medical Center and Medical Group. Maturity, discretion and an ability to maintain confidentiality are of utmost importance.

Enrollment Responsibilities

Responsible for ensuring timely enrollment of new providers with 3rd party payors; and maintenance of existing active physicians.
Responsible for ensuring the timely enrollment of new providers and maintenance of existing providers with the governmental payors including but not limited to Medicare and Medicaid.
Responsible for performing follow up inquiries with payers to ensure timely provider enrollment with payers.
Accountable for overseeing and for directly updating provider data in the CAQH system, as necessary.
Responsible for the on-going maintenance of existing providers, including but not limited to the submission of maintenance forms to update personal and practice demographic data for providers, billing updates, et al.
Accountable for submitting termination requests to all health plans in a timely manner.
Responsible for inputting provider enrollment information into MSOW with flow to EPIC and other Medical Center Health System information systems; and distribution of information to designated department representatives, billing vendors and credentialing administrators.
Produce the weekly enrollment reports.
Adhere to strict guidelines as established to assure payor and NCQA compliance.
Follow organizational policies and procedures as they relate to the provider enrollment process.
Perform other duties as assigned.

Education:

Associate s degree or equivalent experience. Bachelor s degree preferred.

Experience:

Requires 3 years provider enrollment experience in a healthcare system

Knowledge and Skills:

Work requires basic knowledge of credentialing and enrollment procedures / requirements.
Ability to work well with all levels of personnel to establish and maintain harmonious working relationships with providers, chiefs of service, department directors and administrative staff and outside agencies.
Strong communication, time management and organizational skills required to keep a very large and complex system running efficiently.
Ability to prioritize duties and meet deadlines.
Work requires ability to consolidate information from various sources.
Ability to identify problems in the credentialing and enrollment process and strong problem-solving skills needed to resolve any problem as they arise.
Proficiency with Microsoft Office applications (i.e. MS Word, Excel, Access, PowerPoint, Outlook) and web browsers.
Experience with CAQH system and third-party insurance websites a plus.
Skilled in basic computer programs, such as Word and Excel. Experience with Microsoft Office.
Promotes and maintains a professional demeanor both personally and for the Medical Center and the Medical Group.
Able to function independently and perform routine department procedures without supervision.