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Provider Enrollment Coordinator

Careers Integrated Resources Inc Broomfield, CO (Onsite) Contractor
Duties:



Job Summary:

-Coordinates the timely enrollment of new providers (physicians and AHP) and on-going maintenance of existing providers with contracted payers.

-Coordinates all aspects of provider enrollment with commercial and government (Medicare and Medicaid) professional fee payer contracts for an entire market. Ensures enrollment is completed timely and accurately.

-Follows-up with managed care organizations and government payers to ensure timely and accurate enrollment.

-Participates in enrollment progress update meetings for assigned market.

-Provides status information to stakeholders.

-Keeps detailed notes about enrollment progress in provider enrollment database and distributes information to designated department representatives and credentialing administrators.

-Submits provider change and termination requests to all health plans in a timely manner.

-Informs commercial and government payers and internal stakeholders of provider and clinic updates in assigned market.

-Completes all payer re-credentialing requests and demographic/roster requests.

-Completes payer roster comparisons with internal roster twice a year.

-Completes out-of-State Medicaid individual and facility enrollments timely and accurately for assigned States.

-Acts as a payer expert liaison on behalf of the Provider Enrollment team for identified payers.

-SParticipates in team work sessions for each market to address Epic hold and denial work queues and communicate issues and trends to leadership.

-Collaborates with AR to identify claim denial trends and with Coding to identify trend denials related to CPT codes and specific payer types.

-Execute large enrollment provider/payer projects.

-Complete provider enrollment and related duties for organizational clinic acquisitions.

-Collaborates with Recruitment in the onboarding and off-boarding of providers.

-Skills and duties may vary depending upon your department or unit.

-Other duties may be assigned as required.

M-F REMOTE POSITION. HOURS WILL BE MST. 8AM-430P



Skills:



Required Skills & Experience:

-Communicates effectively with all internal and external clients, including managers, employees, vendors, support staff and visitors.

-Uses good judgment and critical thinking skills; ability to identify and resolve problems.

-Proficient in MS Office Suite; particularly Excel, Word, and Outlook.

-Efficient and accurate keyboard/typing skills.

-Possess a strong work ethic and a high level of professionalism with a commitment to client/patient satisfaction.

-Functional knowledge of HIPAA rules and regulations and experience related to privacy laws, access and release of information.



Preferred Skills & Experience:

-N/A
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Job Snapshot

Employee Type

Contractor

Location

Broomfield, CO (Onsite)

Job Type

Other

Experience

Not Specified

Date Posted

11/20/2024

Job ID

24-31112

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