Welcome to One Community Health (OCH), where collaboration is at the heart of everything we do. As a Federally Qualified Health Center (FQHC) serving the Columbia River Gorge region, OCH brings together a diverse team of healthcare professionals, community partners, and stakeholders to deliver comprehensive, coordinated care to individuals and families. Our collaborative approach ensures that every patient receives holistic, patient-centered care that addresses their unique needs and preferences. At OCH, we believe that by working together, we can achieve better health outcomes for our community as a whole. If you're passionate about teamwork, innovation, and making a difference, OCH is the perfect place to grow your career and impact lives.

The Payer Enrollment Coordinator is responsible for timely completion of initial and re-credentialing insurance enrollments for all providers (licensed independent practitioners (LIP), other licensed or certified practitioners (OLCP), and other clinical staff (OCS)). Additionally, this role will research payer credentialing and billing issues and work in conjunction with the Revenue Cycle Manager to identify and resolve issues with provider enrollments. The Payer Enrollment Coordinator collaborates with human resources, clinic leadership, providers, and payers to ensure a smooth and successful credentialing process.

This position is full-time and qualifies for hybrid-remote work after an in-office training period at our Hood River clinic location. This position will require relocation to the Hood River, Oregon or in the surrounding area.

Job Responsibilities:

• Work closely with human resources on notification of a provider's start date, welcome packets, provider documentation and ensuring the provider is in all systems.
• Responsible for obtaining provider delegation and signatures to maintain external credentialing databases.
• Manages and coordinates internal credentialing and re-credentialing processes for LIP and OLCPs within the requirements set by HRSA.
• Oversees and coordinates credentialing activities with third party CVO organization, including regular meetings, follow ups, and priorities of support staff.
• Coordinates communication and follow up for all expirable credentials, ensuring timely renewal, and effective communication to all interested internal and external contacts.
• Supports the completion of HRSA required compliance reporting as it pertains to internal credentialing procedures.
• Researches and resolves billing holds with insurance carriers in Epic.
• Performs timely follow-up with insurance payers via phone, email or website to resolve payer credentialing and billing issues.
• Manage the completion and submission of provider enrollment and re-enrollment applications.
• Perform tracking and follow-up to ensure provider numbers are established and linked to the appropriate location in a timely manner and all payer directories are current.
• Maintain trackers and rosters with current information on enrollment status.
• Understand and maintain documentation for specific application requirements for each payer including pre-requisites, forms required, form completion requirements, supporting documentation (DEA, CV, etc.) and regulations.
• Maintain documentation and reporting regarding provider enrollments in process.
• Setup and maintain providers in the Center for Medicaid/Medicare Services Identity and Access System.
• Maintain and update National Plan and Provider Enumeration System, the Council for Affordable Quality Healthcare’s (CAQH) database of provider information, and the Provider Enrollment Chain of Ownership System, submitting initial enrollments and revalidations in a timely manner and always by due dates.
• Process and maintain civil surgeon/INS applications.
• Retain records related to completed payer credentialing applications in provider credentialing files in collaboration with human resources.
• Work closely with clinic personnel, providers, and billing to expedite completion of forms and requirements including obtaining signatures, locating required documentation, etc.
• Establish close working relationships with privileging personnel, providers, payer provider representatives, and other stakeholders.
• Maintain and update National Plan and Provider Enumeration System and the Council for Affordable Quality Healthcare’s (CAQH) database for new and existing sites.

Minimum Qualifications:

• High School Diploma or GED Required
• Minimum of 2 years of experience completing provider enrollment and credentialing processes in a healthcare setting, with experience across various provider types (Medical, Dental, Behavioral health)
• Minimum of 1 year of experience in a healthcare setting or related administrative role

Preferred Qualifications:

• Associates degree or higher
• FQHC/RHC experience
• Certification in credentialing or planning to complete certification within 6 months of hire. CPCS from NAMSS.

Benefits & Perks:

• Medical, Dental & Vision,
• Life, Disability, Accident, & Critical Illness Insurance
• Empower Retirement 401k Plan
• 200 hours of Paid Time Off (PTO) annually
  • Not including 6 paid Holidays
• Employee Assistance Program (EAP)
• Life Mart- Employee Discounts
• Financial Training with KeyBank
• Employee Wellness Events and Team Challenges
• Local Gym Membership Discounts
• Additional compensation for Bilingual proficiency (English & Spanish)

Compensation:

• Hourly/Non-exempt: $22.00-$24.00/hour, depending on experience.
• Bilingual Differential: Additionally, we offer $0.75 per hour as compensation for bilingual proficiency in both English and Spanish.

OCH is an equal opportunity employer, and we encourage candidates of all backgrounds to apply.