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Job Requirements of Provider Enrollment Coordinator:
-
Employment Type:
Contractor
-
Location:
Broomfield, CO (Onsite)
Do you meet the requirements for this job?
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
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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