Payer Enrollment Coordinator-Onsite

NTT DATA Services currently seeks a Payer Enrollment Cooridinator to join our team in Cumberland, RI. This is a 10 month onsite contract role.

The Enrollment Coordinator will be responsible for ensuring corporate compliance with statutory requirements for Medicare, Medicaid, and Commercial enrollment for Clinics and Providers. This Individual will have the ability to work well with others; collaboratively with internal and external vendors and create partnerships through effective relationship building skills. This role will interact and work directly with new and existing Government /Commercial payers across the country. Analysis will include developing of provider and clinic level reporting insuring we are meeting all criteria for enrollment within our compliance policy for Government /Commercial. The Enrollment Coordinator will interface and work directly with the Providers, and also with Payer Relations and Revenue Cycle Operations Teams (Credentialing, Accounts Receivable, Billing, and Call Center) and Clinical Ops Teams.

Role Responsibilities
This position is responsible, under the supervision of the Manager of the Payer Enrollment Dept. to:

• Ensuring timely and accurate processing of Payer Enrollment applications (Initial and Revalidations) for Clinics and Providers.
• Provide quality control for timely and accurate individual enrollment applications submitted for Medicare and Medicaid programs.
• Resolve claims issues for individual payers in corporate billing system.
• Researching, completing and maintaining compliance with individual Government payers through credentialing, re-credentialing and audit processes and procedures.
• Contact Providers when Revalidation notices are received in order to obtain signature pages and validate current general information.
• The Payer Enrollment Coordinator will be responsible for identifying and quantifying trends/issues and then effectively communicating them to the appropriate members of the management team along with what the potential impact could be.
• Minimize denials and deactivation of government applications where applicable to reduce key metrics including DSO, cost to collect, percent of aged claims, and Bad Debt.
• Update Credentialing and Billing systems with Provider information upon inquiry or receipt from Government /Commercial payers.

Required Experience:

• 2 years of experience with government payers (Medicare/Medicaid)
• 2 years experience in healthcare insurance
• 2 years working experience with Excel

Preferred skills:

• Reliable and consistent attendance
• Strong communication and organizational skills

Education: Verifiable high school diploma or GED REQUIRED

Hours: 7:30-4pm EST

NTT DATA Services is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.

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