Payor Enrollment Coordinator

Payor Enrollment Coordinator

Credentialing Verification Organization - Plano, TX

Position Type:

Full-Time | Hybrid

Schedule:Monday–Friday | 7:30 am-4:30 pm (CT)

Compensation:

$20.00 per hour

Location:

Credentialing OP Division

3801 15th Street

Building A, Suite A300

Plano TX 75075

Why You’ll Love Working With Us

We believe that when employees feel supported, they’re able to thrive both in their careers and in their personal lives. In addition to a strong focus on work–life balance, we offer:

• A comprehensive orientation and training program
• Paid Time Off (PTO) and Extended Illness Days (EID)
• Health, dental, and vision insurance, plus life insurance and prescription coverage
• A 401(k) retirement plan with company match
• Short- and long‑term disability coverage
• Personal and family medical leave

Ready to Make an Impact?

If you enjoy working on the business side of healthcare, love helping people, and want to be part of a team that changes lives every day, this opportunity is for you. We’re excited for you to discover what makes Select Medical such a special place to grow your career! Watch for a glimpse into life at Select Medical!

• Manage all phases of the Non-Delegates Payor Enrollment process for providers and facilities.
• Make determinations as to why claims are rejected and partner with external sources to determine the best resolution.
• Partner with internal resources (Contracting department) to determine the payor credentialing requirements.
• Understand all payors and their requirements in order to build relationships within a specific territory so as to know what questions to ask and from whom to get resolutions.
• Review all contracting for accuracy and partner with payors to ensure the proper credentialing status.
• Complete Payor Enrollment and re-credentialing for facilities and practitioners with all applicable, contracted, Non-Delegated Payors.
• Work with CVO Coordinators for the collection of all payor enrollment requirements such as signature pages, state licenses, proof of liability, etc.
• Complete and track all health plan credentialing and enrollment for practitioners and facilities.
• Serve as a company source of information regarding the status of non-delegated payor credentialing activity.
• Maintain the credentialing database with relevant payor tracking and data.
• Monitor provider and facility status in both internal and external data systems relating to non-delegatedpayor enrollment.
• Maintain all payor enrollment portals such as CAQH, with current information, such as contact information, licensure effective dates and current certificate of liability data.

Minimum Requirements:

• At least 2 years of experience in the credentialing field or a related healthcare field.
• Proficient in Windows (Word, Excel, and Access).
• Ability to be professionally assertive with both internal and external partners to be influential in finding resolutions.
• Strong oral and written communication skills with the ability to interact professionally and positively within all levels of the organization.
• Detail-oriented with good organizational skills and the ability to maintain accuracy while meeting deadlines and production requirements.
• Professional with the ability to work well independently as well as collaboratively with a team.

Preferred Qualifications:

• Experience working in a hospital and/or with Medicare.
• Experience in payor enrollment, facility enrollment, and Medicare/Medicaid.
• Knowledge of credentialing processes, terminology, and NCQA standards.
• Strong analytical skills, including process improvement and problem resolution.

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