Provider Enrollment Coordinator

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

📋 Description

• Provide continuous support and act as a liaison among Medical Staff, Medical Directors, and Administration.

• Oversee the ongoing credentialing and privileging processes along with associated administrative tasks.

• Engage in enrollment progress update meetings and relay status information to relevant stakeholders.

• Maintain comprehensive enrollment progress notes within the provider enrollment database and disseminate information to designated representatives and credentialing administrators.

• Complete requests for payer re-credentialing, demographic updates, roster maintenance, Medicaid, facility, medical group, and individual enrollment.

• Manage Epic hold and denial work queues, reporting issues and trends to leadership.

• Collaborate with Accounts Receivable to identify trends in claim denials, and work with Coding to pinpoint CPT and payer-type denial patterns.

• Coordinate provider enrollment with commercial, Medicare, and Medicaid payer contracts across the entire market.

• Oversee provider enrollment, re-enrollment, and management of expirables.

• Input current expirables, practice/billing locations, and other relevant information into the payer enrollment database.

• Review, complete, and submit enrollment applications via payer portals or other methods.

• Follow up with payers through phone, website, or email about network participation and application status.

• Assist providers and client personnel with applications and troubleshoot enrollment issues.

• Facilitate the completion, setup, and re-attestations of CAQH applications.

• Submit requests for provider changes and terminations to health plans, while updating payers and internal stakeholders accordingly.

• Execute large-scale provider/payer enrollment projects and provide support for clinic acquisitions.

• Collaborate with Recruitment on the onboarding and off-boarding processes for providers.

⛳️ Requirements

• High School Diploma or Equivalent.

• Minimum of one year of experience in a healthcare revenue cycle environment.

• Proficient in computer usage.

• Familiarity with Microsoft Office.

• Strong oral and written communication skills.

• Excellent organizational abilities.

• Keen attention to detail.

• Accountability and capability to work independently.

• Customer service skills.

• Understanding of medical billing and collections.

• Knowledge of medical terminology.

• Frequent computer usage and manual dexterity required.

• Ability to see and read various information, documents, and screens.

• Preferred: One year of experience with government and/or commercial payers in a revenue service environment.

• Preferred: Proven knowledge of medical billing database work queues.

• Preferred: Prior experience with provider enrollment and/or credentialing.

🏝️ Benefits

• Comprehensive benefits package that supports wellness, healthy living, security, connectivity, and engagement.

• Expectations for remote work along with the provision of company equipment.