Provider Enrollment Coordinator Job Orem area,Utah USA,Healthcare

Job Description & How to Apply Below

Fully Remote

Lake Park Building

Full time

R188964

Job Description

Provides ongoing support and coordination as a liaison between the Medical Staff, Medical Directors, and Administration. The position directs the on-going credentialing / privileging process and other administrative functions for the Medical Staff, Medical Director, Administration, and Allied Health Professionals.

Essential Functions

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.
Completes all payer re-credentialing requests and demographic/roster requests.
Completes out-of-State Medicaid individual and facility enrollments timely and accurately for assigned States.
Participates 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.
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.

Skills

Computer literacy
Microsoft Office
Communication (oral and written)
Organizational Skills
Attention to Detail
Accountability/ability to work independently
Customer Service
Knowledge of medical billing and collections
Medical terminology

Job Essentials

Responsible for ensuring timely and accurate facility, medical group, and individual government enrollments for technical and professional fee claim reimbursement.

Coordinates all aspects of provider enrollment with Intermountain Health’s commercial and government (Medicare and Medicaid) professional fee payer contracts for an entire market. Ensures enrollment is completed timely and accurately.
3. Works in all phases of provider enrollment, re-enrollment and expirables management ensuring the timely and accurate enrollment (and recredentialing) of providers in commercial and government payers.

Accurate data entry of up to date expirables, practice/billing locations and other pertinent information to the payer enrollment database.

Participate in review, completion and/or submission of provider enrollment initial and re-enrollment applications for local and national commercial, Medicare, and Medicaid payers via payer online portals or other methods as applicable.

Follow up with payers via phone, website, or email requesting network participation and follow up on submitted applications.

Assist providers, and client personnel with completion of the application, routinely follow up with insurance carriers to monitor the status of applications and resolve issues.

Facilitate completion, set-up and/or re-attestations of CAQH applications.

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 Intermountain stakeholders of provider and clinic updates in assigned market.

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.

Minimum Requirements

High School Diploma or Equivalent

One year experience in a healthcare revenue cycle setting.

Preferred Qualifications

One year of experience working with governments payers and/or commercial payers in a revenue service setting.

Demonstrated knowledge of working medical billing database work queues.

Qualifications

High School graduate or equivalent is required
One (1) year previous work experience in healthcare
Preferred previous work experience in a revenue cycle setting
Preferred previous work experience with provider…

Provider Enrollment Coordinator

Job Description & How to Apply Below

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