Provider Enrollment Coordinator

The Provider Enrollment Coordinator is the first point of contact to staff; resolve enrollment issues by answering questions, making recommendations for resolution and escalation, checking enrollment status, verifying payer enrollment requirements and system implementation, appropriately follow-up on Provider Issue Forms; facilitates group and individual enrollment with commercial and government payers.

• Resolves issues and concerns by correctly answering questions from staff and providing appropriate follow-up on issues, escalating to Team Lead and/or Manager, when appropriate.
• Provides the team with coaching, training, and auditing on assigned tasks. Partner with Team Lead to evaluate team’s performance to improve overall production and facilitate continuous improvement.
• Assists Team Lead in monitoring inventory and production and facilitates the escalation process as needed.
• Become proficient in discussions with payors to facilitate closure of any identified issues
• Research and review individual Provider Issue Forms for appropriate follow-up and resolution.
• Missing Documents - POC will meet with Lead biweekly to review missing documents risks and concerns.
• Maintain Matrices - payer enrollment, matrix, SOPs, new site sheets, email templates, welcome letters, etc.
• Create and distribute reports containing provider credentialing and enrollment data for various departments within the organization
• Research new state enrollment requirements for group and individual provider enrollment.
• Assists Contract Implementation staff with accurately documenting enrollment and billing requirements for payer contracts.
• Assist with IntelliCred Application Mapping
• Facilitate completion and submission of payer enrollment applications for government and commercial payers
• Monitor application status process to identify emerging issues and communicate them to Team Lead
• Monitor enrollment status for group and individuals
• Performs and assists with other department duties as required

• Meticulous follow-through of delegated tasks, including follow-up with staff to ensure completion, quality, and meeting deadlines.
• Ability to exhibit leadership by demonstrating a commitment to team development, adapting to change in a positive manner, and supporting alignment with organizational goals including continuous improvement efforts
• Ability to pay close attention to detail and produce extremely accurate work.
• Strong analytical and problem-solving skills.
• Ability to organize and prioritize job tasks and requirements.
• Excellent organization skills with the ability to prioritize assigned duties in an efficient amount of time.
• Ability to effectively perform in a multi-task work environment.
• Strong communication and interpersonal skills.
• Ability to effectively use oral and written communication skills with clinicians, external agencies and management in a courteous and professional manner.
• Must have knowledge of correct English, proper grammar and spelling.
• Knowledge and skills in using personal computers (Windows) with a strong emphasis on Microsoft Office Programs- Outlook, Word, Excel and Adobe Acrobat
• Ability to maintain patience and composure in difficult situations.
• Ability to work well under pressure and meet strict deadlines.
• Ability to maintain confidentiality.
• Ability to exhibit a commitment to teamwork, supporting alignment with company and department goals and objectives, assisting others to develop their knowledge of the company and department, and adapting to changes in a positive manner.

• High school diploma or equivalent
• Two (2) years office experience or college course work preferred.
• Knowledge of health plan billing and enrollment preferred.

• While performing the duties of this job, the employee is regularly required to sit for prolonged periods and occasionally walk, stand, bend, stoop, and lift up to 15 pounds.
• Required to have close visual acuity to perform the job.