Provider Enrollment Coordinator

Thomas Jefferson University & Jefferson Health; Philadelphia (Philadelphia County); On-site; USD 45,000 - 60,000; Full time

Job summary

A leading healthcare institution in Philadelphia is seeking a dedicated individual to manage physician enrollment and billing processes. The role involves ensuring compliance with 3rd party carriers, maintaining provider documentation, and supporting the revenue cycle. Ideal candidates will have a strong healthcare background and excellent organizational skills, with proficiency in relevant software and systems.

Qualifications

• High school graduate or equivalent required.
• Healthcare background and experience in 3rd party physician billing preferred.

Responsibilities

• Ensures all physicians are enrolled in appropriate 3rd party carriers.
• Handles provider revalidations for all payers and CMS regulatory sites.
• Manages and updates all related system applications.

Skills

Organizational Skills

Healthcare Background

3rd Party Billing

Network Data Experience

Knowledge of CAQH

Proficiency in Excel

Proficiency in Word

Education

High School Graduate

Tools

IDX Software

Job description

Job Details

Ensures that all physicians are enrolled in the appropriate 3rd party carriers. Obtains all necessary provider numbers, signatures, credentialing information, and other pertinent documentation for the 3rd party carrier plans for which we have an approved contract. Maintains provider dictionary and provides management with provider status reports. Handles all provider revalidations for all payers and CMS regulatory sites. Reviews network change form requests for provider changes, additions, deletions to network providers, locations, NPI numbers, and taxonomy, which drive claims reimbursement. Manages and updates all related system applications and claims edits to add provider numbers and release all provider claims on hold—directly impacting the revenue cycle.

Job Description

Education/Training/Experience:

• High school graduate or equivalent required.
• A healthcare background is strongly preferred.
• Experience in all aspects of 3rd party physician billing is preferred.
• Extensive knowledge of physician enrollment processing is preferred.
• Network data experience is important and can substitute for other aspects of 3rd party billing.
• Knowledge of CAQH, PECOS, NPPES systems is helpful.
• Proficiency in Excel and Word is preferred.
• IDX software experience is preferred.
• Excellent organizational skills are required.

Work Shift

Day shift (United States of America)

Worker Sub Type

Regular

Primary Location Address

101 E Olney Ave, Philadelphia, Pennsylvania, United States of America