Provider Enrollment Coordinator
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Job Description
Provider enrollment coordinator managing commercial, Medicare, and Medicaid enrollment for Intermountain Health. Tracking applications, recredentialing, denials, and provider onboarding.
Responsibilities:
- Provide ongoing support and coordination as a liaison between Medical Staff, Medical Directors, and Administration
- Direct the ongoing credentialing and privileging process and related administrative functions
- Participate in enrollment progress update meetings and provide status information to stakeholders
- Maintain detailed enrollment progress notes in the provider enrollment database and distribute information to designated representatives and credentialing administrators
- Complete payer re-credentialing, demographic, roster, Medicaid, facility, medical group, and individual enrollment requests
- Address Epic hold and denial work queues and communicate issues and trends to leadership
- Collaborate with Accounts Receivable to identify claim denial trends and with Coding to identify CPT and payer-type denial trends
- Coordinate provider enrollment with commercial, Medicare, and Medicaid payer contracts for an entire market
- Manage provider enrollment, re-enrollment, and expirables
- Enter current expirables, practice/billing locations, and other information into the payer enrollment database
- Review, complete, and submit enrollment applications through payer portals or other methods
- Follow up with payers by phone, website, or email regarding network participation and application status
- Assist providers and client personnel with applications and resolve enrollment issues
- Facilitate CAQH application completion, setup, and re-attestations
- Submit provider change and termination requests to health plans and communicate updates to payers and internal stakeholders
- Execute large enrollment provider/payer projects and support clinic acquisitions
- Collaborate with Recruitment on provider onboarding and off-boarding
Requirements:
- High School Diploma or Equivalent
- One year experience in a healthcare revenue cycle setting
- Computer literacy
- Microsoft Office
- Oral and written communication
- Organizational skills
- Attention to detail
- Accountability/ability to work independently
- Customer service
- Knowledge of medical billing and collections
- Medical terminology
- Frequent computer use and manual dexterity
- Ability to see and read information, documents, and monitors
- Preferred: one year of experience working with government and/or commercial payers in a revenue service setting
- Preferred: demonstrated knowledge of medical billing database work queues
- Preferred: previous work experience with provider enrollment and/or credentialing
Benefits:
- Generous benefits package covering programs for wellness, living healthy, happy, secure, connected, and engaged
- Remote work expectations and use of company equipment
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