Provider Enrollment Coordinator

Intermountain Healthcare Inc.; Jackson (MS); Sur place; USD 31 000 - 47 000; Plein temps

Avantages offerts par ce poste

Generous benefits package

PEAK tuition program

Résumé du poste

Intermountain Health in Utah is seeking a credentialing/enrollment coordinator to manage timely provider enrollment across commercial and government payers. You will coordinate with Medical Staff, Directors, andAdministration to ensure accurate enrollment, re-credentialing, and CAQH activities.

You will perform data entry, payer portals submissions, and follow-ups while collaborating with AR, Coding, and Recruitment on market initiatives.

Qualifications

• High School Diploma or Equivalent.
• One year experience in a healthcare revenue cycle setting.
• Experience with government payers and/or commercial payers preferred.
• Preferred experience with provider enrollment and credentialing.

Responsabilités

• Responsible for ensuring timely and accurate facility, medical group, and individual government enrollments for technical and professional fee claim reimbursement.
• Coordinates all aspects of provider enrollment with Intermountain Health’s commercial and government payers for an entire market.
• Accurate data entry of up-to-date expirables, locations, and other pertinent information to the payer enrollment database.
• Submit provider enrollment applications for local and national payers via portals or other methods.
• Follow up with payers to request network participation and status of applications.
• Assist providers with application completion and monitor status with insurers.
• Facilitate CAQH applications setup and attestations.
• Participate in enrollment progress update meetings and share status with stakeholders.
• Submit provider changes to health plans in a timely manner and inform internal stakeholders.
• Collaborate with teams to identify denial trends related to CPT codes and payer types.
• Execute large enrollment projects and assist with clinic acquisitions and onboarding/offboarding.

Connaissances

Computer literacy

Microsoft Office

Communication

Organizational skills

Attention to detail

Independent work

Customer service

Medical billing knowledge

Medical terminology

Formation

High School Diploma or Equivalent

Outils

Epic

Description du poste

Fully Remote

Lake Park Building

Full time

R188964

Job Description

Provides ongoing support and coordination as a liaison between the Medical Staff, Medical Directors, and Administration. The position directs the on-going credentialing / privileging process and other administrative functions for the Medical Staff, Medical Director, Administration, and Allied Health Professionals.

Essential Functions

• Participates in enrollment progress update meetings for assigned market. Provides status information to stakeholders. Keeps detailed notes about enrollment progress in provider enrollment database and distributes information to designated department representatives and credentialing administrators.
• Completes all payer re-credentialing requests and demographic/roster requests.
• Completes out-of-State Medicaid individual and facility enrollments timely and accurately for assigned States.
• Participates in team work sessions for each market to address Epic hold and denial work queues and communicate issues and trends to leadership. Collaborates with AR to identify claim denial trends and with Coding to identify trend denials related to CPT codes and specific payer types.
• Coordinates all aspects of provider enrollment with commercial and government (Medicare and Medicaid) professional fee payer contracts for an entire market. Ensures enrollment is completed timely and accurately. Follows-up with managed care organizations and government payers to ensure timely and accurate enrollment.

Skills

• Computer literacy
• Microsoft Office
• Communication (oral and written)
• Organizational Skills
• Attention to Detail
• Accountability/ability to work independently
• Customer Service
• Knowledge of medical billing and collections
• Medical terminology

Job Essentials

1. Responsible for ensuring timely and accurate facility, medical group, and individual government enrollments for technical and professional fee claim reimbursement.
2. Coordinates all aspects of provider enrollment with Intermountain Health’s commercial and government (Medicare and Medicaid) professional fee payer contracts for an entire market. Ensures enrollment is completed timely and accurately. 3. Works in all phases of provider enrollment, re-enrollment and expirables management ensuring the timely and accurate enrollment (and recredentialing) of providers in commercial and government payers.
3. Accurate data entry of up to date expirables, practice/billing locations and other pertinent information to the payer enrollment database.
4. Participate in review, completion and/or submission of provider enrollment initial and re-enrollment applications for local and national commercial, Medicare, and Medicaid payers via payer online portals or other methods as applicable.
5. Follow up with payers via phone, website, or email requesting network participation and follow up on submitted applications.
6. Assist providers, and client personnel with completion of the application, routinely follow up with insurance carriers to monitor the status of applications and resolve issues.
7. Facilitate completion, set-up and/or re-attestations of CAQH applications.
8. Participates in enrollment progress update meetings for assigned market. Provides status information to stakeholders. Keeps detailed notes about enrollment progress in provider enrollment database and distributes information to designated department representatives and credentialing administrators.
9. Submits provider change and termination requests to all health plans in a timely manner. Informs commercial and government payers and internal Intermountain stakeholders of provider and clinic updates in assigned market.
10. Collaborates with AR to identify claim denial trends and with Coding to identify trend denials related to CPT codes and specific payer types.
11. Execute large enrollment provider/payer projects. Complete provider enrollment and related duties for organizational clinic acquisitions. Collaborates with Recruitment in the onboarding and off-boarding of providers.

Minimum Requirements

High School Diploma or Equivalent

One year experience in a healthcare revenue cycle setting.

Preferred Qualifications

One year of experience working with governments payers and/or commercial payers in a revenue service setting.

Demonstrated knowledge of working medical billing database work queues.

Qualifications

• High School graduate or equivalent is required
• One (1) year previous work experience in healthcare
• Preferred previous work experience in a revenue cycle setting
• Preferred previous work experience with provider enrollment and/ or credentialing

Physical Requirements

• Ongoing need for employee to see and read information, documents, monitors, identify equipment and supplies, and be able to assess customer needs.
• Frequent interactions verbally and written with providers, colleagues and leadership
• Frequent computer use for typing, accessing needed information, etc.
• Manual dexterity of hands and fingers.

Location

Lake Park Building

Work City

West Valley City

Work State

Utah

Scheduled Weekly Hours

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$22.39 - $34.06

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.

Intermountain Health’s PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution. The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates. Caregivers are eligible to participate in PEAK on day 1 of employment. Learn more. (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/peak-program/)

The primary intent of this job description is to set a fair and equitable rate of pay for this classification. Only those key duties necessary for proper job evaluation and/or labor market analysis have been included. Other duties may be assigned by the supervisor.

Intermountain Health strives to make the application process accessible to all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact 1-800-843-7820 or email [e-mail] . This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.