Point of Contact, Provider Enrollment

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

📋 Description

• Oversee the enrollment status for both group and individual providers.

• Address enrollment challenges by responding to staff inquiries, offering recommendations, confirming payer requirements, and ensuring follow-up actions.

• Serve as the main point of contact for the Provider Enrollment team and escalate complex issues when needed.

• Provide coaching, training, and conduct quality audits for assigned tasks.

• Monitor inventory and production metrics, manage workflow, and ensure timely escalation of issues.

• Collaborate with payers to resolve enrollment challenges.

• Investigate and assess Provider Issue Forms to determine necessary follow-up actions.

• Evaluate risks associated with missing documentation and implement timely mitigation strategies.

• Maintain payer enrollment matrices, standard operating procedures (SOPs), site sheets, email templates, and welcome letters.

• Create and disseminate reports on provider credentialing and enrollment data.

• Keep updated on state enrollment requirements.

• Record enrollment and billing requirements linked to payer contracts.

• Assist with IntelliCred Application Mapping initiatives.

• Facilitate the completion and submission of payer enrollment applications for both government and commercial payers.

• Track application statuses and communicate any emerging issues for quick resolution.

• Perform additional departmental duties as needed.

⛳️ Requirements

• High school diploma or equivalent is required.

• At least 2 years of experience in healthcare provider enrollment is necessary.

• Experience with government and commercial payers is highly preferred.

• Previous experience in a dynamic healthcare setting is a plus.

• Strong follow-through on assigned tasks, ensuring completion, quality, and compliance with deadlines.

• Proven leadership skills, including a commitment to team development, adaptability to change, and alignment with organizational objectives and continuous improvement efforts.

• Exceptional attention to detail.

• Strong analytical and problem-solving abilities.

• Capability to organize, prioritize, and efficiently manage multiple tasks.

• Excellent organizational skills with the ability to meet deadlines.

• Strong communication and interpersonal skills.

• Proficient in oral and written communication.

• Skilled in Windows and Microsoft Office applications, including Outlook, Word, Excel, and Adobe Acrobat.

• Ability to maintain patience and composure in challenging situations.

• Capacity to perform well under pressure and meet tight deadlines.

• Commitment to confidentiality and proper handling of sensitive information.

• Dedication to teamwork and a positive approach to change.

🏝️ Benefits

• Options for medical, dental, and vision insurance.

• Health savings accounts (HSA) and flexible spending accounts (FSA).

• 401(k) contributions from both employees and employers.

• Paid time off, which includes vacation, sick leave, and company holidays.

• Paid parental leave and family support benefits.

• Short-term and long-term disability insurance.

• Life insurance and accidental death & dismemberment (AD&D) insurance.

• Employee assistance programs and wellness resources.

• Eligibility for bonuses, equity, or other incentive programs, depending on the position.