Provider Enrollment & Credentialing Coordinator

• Job Type: Officer of Administration
• Regular/Temporary:
  Regular
• Hours Per Week: 35
• Standard
  
  Work Schedule:
  
  Core business hours Monday-Friday, schedules vary
• Building: 400 Kelby Street, Fort Lee NJ
• Salary Range: $66,300.00 - $70,000.00

The compensation range listed in this job posting reflects the market rate for the New York City Metropolitan area. Actual compensation may vary depending on the geographic location of the candidate, in accordance with local labor market conditions.

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to departmental budgets, qualifications, experience, education, licenses, specialty, and training. The above hiring range represents the University's good faith and reasonable estimate of the range of possible compensation at the time of posting.

Position Summary

The Provider Enrollment Coordinator performs provider enrollment functions for delegated, non-delegated, government, and third-party payers/vendors. This role supports enrollment, reenrollment, profile maintenance, updates, disenrollments, and resolution of payer-related issues. The coordinator ensures that provider records are accurate, compliant, and maintained in accordance with enrollment timelines, payer requirements, and internal standards. While the core focus is enrollment, the role may support credentialing activities as needed to maintain workflow continuity and compliance.

Responsibilities

Technical

• Coordinate enrollment and credentialing tasks for delegated, non-delegated, government, and third-party payers/vendors.
• Assist in preparing, submitting, and tracking individual and group provider enrollment submissions, including applications, rosters, revalidations, group linkages, demographic updates, and terminations.
• Support a variety of enrollment scenarios by preparing documentation, completing standard applications, performing data validation, and tracking enrollment progress. Support escalations or complex cases by gathering requirements, identifying issues, and assisting with resolution follow-up.
• Support quality assurance (QA) efforts by reviewing application components for completeness and flagging potential compliance issues based on payer-specific guidelines. Ensure documentation integrity.
• Maintain accurate and organized provider files in accordance with internal record-keeping standards.
• Utilize up-to-date payer forms and enrollment documentation in alignment with established departmental SOPs and workflow guides.
• Maintain and update payer portals (e.g., PECOS, Availity, eMedNY) to support accurate provider profiles and track enrollment status; assist with identifying the appropriate application type (e.g., full application, group link, revalidation); and support submission of follow-up applications when needed to complete or correct enrollment records.
• Track and document enrollment status from submission through confirmation using internal tools, ensuring timely processing and accurate system updates. Conduct systematic follow-up via email, phone, and payer systems to confirm application receipt and approval. Provide regular updates on outstanding requests, aging items, and any delays impacting submission timelines. Escalate incomplete submissions, delays, or errors in accordance with established escalation protocols.
• Support profile maintenance for providers by processing updates to licenses, DEA registrations, specialties, TINs, service addresses, hospital affiliations, board certifications, and more to ensure enrollment records remain current and compliant.
• Follow up with departments to obtain missing documentation or signatures to support timely application submission.
• Log, troubleshoot, and track enrollment-related issues such as denials/underpayments, authorization issues, or other participation errors. Collaborate with internal departments and payer contacts to complete a comprehensive root-cause analysis, following through to resolution to minimize adverse impact to revenue and patient/provider abrasion. Escalate issues appropriately for review and resolution.
• Perform routine roster audits for lower-volume payers to identify and…