Provider Enrollment Coordinator
Marcy, NY 13403
Flexible schedule offered! Pay is dependent on experience!
This Provider Enrollment Coordinator is responsible for the timely enrollment of new physicians and on-going maintenance of existing providers. Enrollment includes commercial, managed care and governmental organizations. Ensure provider data is loaded appropriately in all relevant systems the first time.
Understand and communicate unique arrangements and ensuring the third party payers accurately credential the provider
Become proficient with credentialing software (Intellicred) and electronic filing system.
Document all actions taken through follow up of outstanding applications.
Enter and update provider data into the NPI and CAQH systems
Complete initial enrollment with insurance companies for all new providers
Follow up timely with payers to ensure expedient credentialing
Work closely with physicians and office mangers to obtain missing documentation on providers for enrollment with insurance companies
Responsible for the on-going maintenance of existing providers including, but not limited to, the submission of maintenance forms to update demographic data.
Ensure third party payer provider enrollment is done timely and accurately in order to receive reimbursement
Complete re-credentialing for participating providers as required by carrier.
Able to effectively communicate with team members, billing staff and insurance companies
Communicate with billing and the office managers on updates as needed and explain payer information requirements
Respond to and complete all Demographic Verifications as needed/requested.
Submit termination notices to all health plans in a timely manner as requested by practice.
Update and retain detailed and accurate lists of insurances for which clients participate
Complete daily task list within established time frames
Scan, Fax, Email and E-File as required to maintain accurate and complete files
Maintain insurance line of business participation by provider
Maintain accurate breakdown of contractual reimbursements by provider/client
Other duties as assigned
High School Diploma or equivalent, Required
Associates Degree, Preferred
Minimum 2 years experience in the healthcare industry, Required
Working knowledge of Microsoft Office Suite