Enrollment Coordinator

Requirements

• At least two (2) years of experience with insurance verification, billing and/or provider relations (or medical insurance verification/provider relations).
• Working knowledge of insurance billing/provider operations within a large healthcare organization.
• Knowledge of Medicare and Medicaid policies and procedures.
• Basic proficiency with MS Word, PowerPoint, and Excel.
• Knowledge of the ECHO, NAVINET, and CAQH systems.
• Solid critical thinking and problem‑solving skills.
• Solid analytical and organizational skills.
• Ability to collaborate with stakeholders at all levels.

Responsibilities

• Reviews and prepares new hire enrollment packets for accuracy, completeness, and timely submission to payers; maintains current provider information to ensure timely reimbursement.
• Performs follow‑up with physicians to request necessary documentation for application/re‑credentialing; sends renewal reminders 30 days prior to expiration.
• Maintains working knowledge of payer processes and updates; ensures physician database and NPPES system are accurate and current.
• Maintains files, scans credentials, monitors expiration dates, and notifies administrators and Enrollment Manager of deadlines.
• Initiates phone calls, generates letters and other correspondence for follow‑up with payers to secure provider participation effective dates and numbers (goal within 60 days of payer receipt of application).
• Documents all contacts and discussions with payers; retains copies of emails and written correspondence sent to third‑party payers for future reference.
• Reviews and provides research results to the Billing Department to assist with claims issue resolution.