Provider Enrollment Coordinator

10700 Revenue Cycle Organization; United States; On-site; USD 31,000 - 47,000; Full time

Job summary

Intermountain Health in Utah seeks an Enrollment Specialist to coordinate full-cycle provider enrollment across commercial and government payers. You will manage enrollment, re-enrollment, and expirables, ensuring timely data entry and updates in the payer system.

You will collaborate with AR, Coding, and Recruitment to address denial trends and support market enrollment for Medicare, Medicaid, and local payers. Strong organization and communication are essential.

Qualifications

• High School Diploma or Equivalent
• One year experience in a healthcare revenue cycle setting.

Responsibilities

• Ensures enrollment is completed timely and accurately.
• Coordinates all aspects of provider enrollment with Intermountain Health’s commercial and government (Medicare and Medicaid) professional fee payer contracts for an entire market.
• 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.
• Accurate data entry of up to date expirables, practice/billing locations and other pertinent information to the payer enrollment database.
• 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.
• Follow up with payers via phone, website, or email requesting network participation and follow up on submitted applications.
• 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.
• Facilitate completion, set-up and/or re-attestations of CAQH applications.
• Submits provider change and termination requests to all health plans in a timely manner.

Skills

Computer literacy

Microsoft Office

Communication (oral and written)

Organizational Skills

Attention to Detail

Accountability/ability to work indep.

Customer Service

Knowledge of medical billing and coln.

Medical terminology

Education

High School Diploma or Equivalent

Job description

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.
• 4. Accurate data entry of up to date expirables, practice/billing locations and other pertinent information to the payer enrollment database.
• 5. 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.
• 6. Follow up with payers via phone, website, or email requesting network participation and follow up on submitted applications.
• 7. 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.
• 8. Facilitate completion, set-up and/or re-attestations of CAQH applications.
• 9. 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.
• 10. 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.
• 11. Collaborates with AR to identify claim denial trends and with Coding to identify trend denials related to CPT codes and specific payer types.
• 12. 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.

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 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.

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment.

All positions subject to close without notice.

Headquartered in Utah with locations in six primary states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 34 hospitals, 400+ clinics, a medical group of more than 4,800 employed physicians and advanced care providers, a health plan division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery.

Join our world-class team and embark on a career filled with opportunities, strength, innovation, and fulfillment.

To find out more about us, head to our career site here.

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.

Introduce yourself to our Talent Acquisition team and we will get in touch if there is a role that seems like a good match.

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.

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.

Thanks for your interest in continuing your career with our team!