Enrollment Coordinator

VOLTO Consulting; Philadelphia (Philadelphia County); On-site; USD 42,000 - 62,000; Full time

Job summary

VOLTO Consulting is seeking a detail-oriented professional for insurance verification, billing and provider relations in a healthcare setting. The role requires at least two years of relevant experience and strong organizational skills.

You will coordinate with payers, maintain provider information, support enrollment and re-credentialing, and ensure timely reimbursement. Knowledge of Medicare/Medicaid, ECHO, NAVINET and CAQH and MS Office is essential; collaboration with stakeholders at all

Qualifications

• Minimum two years of experience in insurance verification or billing.
• Experience in provider relations within a healthcare organization.
• Knowledge of Medicare and Medicaid policies.

Responsibilities

• Reviews and prepares new hire enrollment packets for accuracy and timely submission to payers and maintains provider information for timely reimbursement.
• Performs follow-up with physicians to obtain documentation for enrollment/re-credentialing (renewals due 30 days before expiration).
• Maintains knowledge of payer processes and keeps physician database and NPPES current.
• Maintains files, scans credentials, and notifies administrators of deadlines.
• Initiates calls and correspondence to payers to ensure timely receipt of enrollment dates and numbers.
• Documents all payer contacts and correspondence for future reference.
• Reviews and provides research to Billing to assist with claims issue resolution.

Skills

Insurance verification

Billing

Provider relations

Payer processes

Analytical thinking

Tools

ECHO

NAVINET

CAQH

Job description

Required Skills & Experience

• At least two (2) years Previous experience with insurance verification, billing and/or
• At least two (2) years Previous experience with insurance verification, billing and/or
• At least two (2) years medical insurance verification/provider relations.
• Working knowledge of insurance billing/provider operations within a large healthcare organization.
• Knowledge of Medicare and Medicaid policies and procedures.
• Basic proficiency with MS Word, Power Point, Excel computer programs.
• Knowledge of the ECHO, NAVINET and CAQH systems.
• Solid critical thinking / problem-solving skills.
• Solid analytical and organizational skills.
• Ability to collaborate with stakeholders at all levels.

provider relations.

OR

Job Responsibilities

• Provides reviews and prepares new hire enrollment packets for accuracy, completeness and timely submission to the payers and maintains current provider information in order to ensure timely reimbursement of payment for services.
• Performs follow-up with the physicians to request necessary documentation for the application/re-credentialing process (Renewal reminders must be sent 30 days prior to the expiration date).
• Maintains a working knowledge of payers processes and updates and ensures that the physician database and NPPES system is kept accurate and current.
• Maintains files, scans credentials and monitors expiration dates and notifies administrators and Enrollment Manager of deadlines.
• Initiates phone calls, generates letters and other correspondence as required for follow up with payers to ensure timely receipt of provider participation effective dates and numbers (goal is within 60 days of payer receipt date of the application).
• Assures that all contacts and discussion with payers are documented and maintained, as well as copies of emails and/or written correspondence sent to third party payers, for future reference.
• Reviews and provides research results to the Billing Department to assist with claims issue resolution.

Application Question(s)

• Knowledge of the ECHO, NAVINET and CAQH systems.