Provider Enrollment Coordinator [AQ-11564]

About The Hiring Company

Our client is a prominent entity in the healthcare sector, dedicated to transforming the health experience. They leverage innovative technology and comprehensive services to enhance care delivery and improve patient outcomes. Joining their team means becoming part of an organization committed to excellence and making a tangible difference in the lives of many.

The Opportunity to Make an Impact

Are you a highly organized and detail-oriented individual ready to step into a pivotal role where your work directly impacts patient care? We are seeking a dynamic professional to become instrumental in the critical process of enrolling healthcare providers. In this position, you will directly influence the accessibility and quality of patient care by navigating complex regulatory landscapes, ensuring that physicians and groups are properly credentialed and integrated into essential healthcare programs. Your meticulous efforts will uphold the integrity of provider networks and powerfully support the overarching mission of delivering exceptional health services.

What You'll Do

• Work effectively within a deadline-driven environment to process applications efficiently.
• Engage professionally with providers and staff to gather and provide necessary documentation.
• Strategically plan, prioritize, and organize tasks to meet established objectives and turnaround times.
• Monitor and follow up with providers to ensure timely submission of all required documents and applications.
• Assist in maintaining consistency and accuracy of data across various systems.
• Validate data for provider databases, ensuring compliance with business and system requirements for contracting, network management, and credentialing.
• Demonstrate in-depth knowledge of and execute all standard operating procedures, communicating issues, trends, and suggestions to leadership.
• Apply a thorough understanding of various payer applications and their associated workflow processes.
• Ensure all workflow items are completed within set turn-around-times while consistently meeting quality expectations.

Must-Have Qualifications

• 1-3 years of experience in a centralized credentialing office, with direct experience in provider enrollment, credentialing, or file maintenance.
• Proficiency in Microsoft Word and Excel.
• Knowledge of health plan and governmental payer credentialing, enrollment, and requirements, typically gained through a CPCS certification course or equivalent job-related experience, with an intent to pursue certification.
• Familiarity with federal and state healthcare enrollment applications.

Nice-to-Have Qualifications

• Experience with credentialing and enrollment software.
• Knowledge of industry accreditation standards interpretation.