Part-time Enrollment Coordinator

This is a fully remote position, open to applicants in South Carolina.

📋 Description

• Receive notifications from the Clinician Onboarding Liaison (COL).

• Collaborate closely with the recruiting team during the onboarding of new providers and provide weekly updates on credentialing enrollment status with payors.

• Obtain and maintain credentialing documentation for both new and existing providers, including items that are nearing expiration.

• Supply information on providers for review and approval by the Credentialing Committee.

• Escalate any provider credentialing and payor issues to the Director as necessary.

• Track, generate, and prepare applications for providers.

• Conduct payer research and include providers in the Credentialing report.

• Review returned credentialing packets for accuracy and communicate updates to providers.

• Analyze weekly exception reports and prioritize urgent issues.

• Follow up with providers concerning any unreturned paperwork.

• Dispatch updated credentials to payers and complete payer credentialing applications for new facilities across multiple states.

• Investigate state requirements and formulate Standard Operating Procedures (SOPs).

• Assist with new facility enrollment as well as individual location enrollment in emerging markets.

• Keep stakeholders updated on challenges faced in new markets.

• Manage notifications and withdrawals of provider employment.

• Generate necessary payer paperwork for revalidations and initiate re-credentialing processes.

• Collaborate with the COL, credentialing coordinators, and stakeholders to enroll providers and facilities with Medicaid, Medicare, commercial, and managed care plans.

• Meet with health plans to ascertain provider statuses and resolve claims issues, including holds and denials.

• Work with payors to ensure timely enrollment and maintain active status.

• Escalate trends and issues to Revenue Cycle Management (RCM), operations, and other stakeholders.

• Maintain provider enrollment processes and manage credentialing databases/websites/portals such as CAQH, NPPES, Navinet, Availity, and PECOS.

• Support the Provider Enrollment Department, aid the contracting department, and collaborate with RCM on payer issues related to credentialing.

⛳️ Requirements

• A minimum of 2 years of successful work experience in physician credentialing and/or physician enrollment.

• Familiarity with provider credentialing databases/websites/portals (e.g., CAQH, NPPES, and PECOS).

• Experience with Modio software is preferred.

• Working knowledge of the revenue cycle process.

• Overtime may be required as directed by Management.

• Expected working hours are 20 hours per week.

🏝️ Benefits

• Flexible schedule.

• Excellent training provided for those new to this field.

• Mileage reimbursement (if applicable); Crossroads matches the current IRS mileage reimbursement rate.

• Calm subscription available for all employees.