Provider Enrollment Coordinator | Remote | (GC)/(USC)

The Provider Enrollment Coordinator is dedicated to ensuring the accuracy and timeliness of updates to internal databases, prioritizing the integrity of the provider file. This role requires handling confidential information with the utmost integrity and involves the meticulous maintenance of data in both internal and external databases, serving the purpose of provider and payer enrollment.

Responsibilities:

· Cultivate professional and effective interactions with co-workers, clients, providers, and vendors.
· Respond promptly to inquiries, providing clear and comprehensive explanations of requirements.
· Maintain continuous and open communication with payer representatives to ensure the appropriate enrollment of providers.
· Exercise discretion and confidentiality when handling sensitive information.
· Act as the primary point of contact for providers navigating the enrollment process, offering guidance and support.
· Keep application information up to date in the company system, ensuring accuracy and completeness.
· Manage information and documentation with a focus on confidentiality and security.
· Meet and exceed required SLA and productivity standards.
· Strive for efficiency and effectiveness in all aspects of the provider enrollment process.
· Release individual claims for providers after thorough review and independently resubmit claims with necessary corrections.
· Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules. Required Qualifications
· High School Diploma or equivalent
· 3+ years of experience working in a billing, health insurance, physician practice, or equivalent operations environment
· 3+ years of provider enrollment experience

Preferred Qualifications

· In-depth knowledge of provider enrollment requirements for Government agencies, payor organizations, and insurance regulations
· Proficient in rapidly acquiring proficiency in new software programs
· Substantial experience in dealing with Medicare, Commercial Healthcare insurance, and Medicaid agencies
· Demonstrated ability to effectively prioritize and organize multiple tasks
· Exceptional attention to detail
· Proven ability to thrive in a team-oriented environment, coupled with excellent organizational, writing, and oral communication skills
· Competency in Spread-sheet Design and advanced use of Excel
· Practical experience with essential computer software, including Word, Excel, and Outlook