Remote Provider Enrollment Coordinator

* Receives notifications from the Clinician Onboarding Liaison (COL).* Work closely with recruiting team during the onboarding process of new providers and provide weekly credentialing updates as to status of enrollment with payors.* Obtain and maintain provider credentialing documents for new and existing providers, including expiring documentation.* Provides timely and pertinent information on providers for Credentialing Committee review and approval.* Escalates Provider Credentialing issues to the Director, as needed.* Escalates payor issues to Director, as needed.* Tracks, generates, and prepares applications to send to provider.* Conducts payer research on the provider.* Adds providers to the Credentialing report.* Reviews returned packets for accuracy and communicates updates to the Providers.* Review weekly exception reports from management to prioritize critical issues.* Follows up with providers for un-returned paperwork.* Sends updated credentials to the payer and complete payer credentialing applications for new facility locations in multiple states.* Research state requirements prior to entry into the state and creates SOP regarding same.* Works with Director and other key stakeholders on all new facilities including enrollment of facilities and individual locations into new markets.* Keeps all key stakeholders informed of any challenges faced in new markets.* Primary point of contact for withdrawal of provider's employment; receive and update and notify others, if needed.* Generate correct payer paperwork for re-validations/begin re-credentialing process.* Partner with COL, credentialing coordinators and other key stake holders in onboarding and enrollment providers and facilities with Medicaid, Medicare, commercial and managed care plans.* Maintenance of provider enrollment processes and credentialing databases/websites/portals including CAQH, NPPES, Navinet, Availity, PECOS.* Support overall Provider Enrollment Department, assist contracting department with requests as necessary and work with RCM to assist with payer issues related to credentialing.* Meets at least monthly with health plans (more if needed) to obtain statuses of providers and to address any claims issues including holds and denials.* Works with payors to ensure timely enrollment & active status.* Escalates trends and issues to RCM, operations, and other key stake holders as needed.* Minimum of 2 years of successful work experience in physician credentialing and/or physician enrollment.* Experience with provider credentialing databases/websites/portals (i.e.- CAQH, NPPES and PECOS).* Experience with Modio software preferred.* Working knowledge of the revenue cycle process.* Overtime may be required by Management.* Medical, Dental, and Vision Insurance* PTO* Variety of 401K options including a match program with no vesture period* Annual Continuing Education Allowance (in related field)* Life Insurance* Short/Long Term Disability* Paid maternity/paternity leave* Mental Health day* *Calm* subscription for all employees #J-18808-Ljbffr