Remote Provider Enrollment Credentialing Coordinator

Intermountain Healthcare Inc.; Denver (CO); Remote; USD 31,000 - 47,000; Full time

Benefits offered by this job

PEAK program

Remote work options

Job summary

Intermountain Health in Utah is seeking a Credentialing Coordinator to manage the ongoing enrollment and re-credentialing for government and commercial payers across a market. You will coordinate provider enrollment, data entry, and CAQH attestations.

The role requires attention to detail, healthcare revenue cycle experience, and strong collaboration with AR, Coding, and recruitment to resolve enrollment issues and denial trends.

Qualifications

• High School Diploma or Equivalent
• One year experience in a healthcare revenue cycle setting
• One year of experience with government payers and/or commercial payers in a revenue service setting
• Demonstrated knowledge of working medical billing database work queues

Responsibilities

• 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 (Medicare and Medicaid) professional fee payer contracts for an entire market. Ensures enrollment is completed timely and accurately.
• 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.
• 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.
• 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.
• Collaborates with AR to identify claim denial trends and with Coding to identify trend denials related to CPT codes and specific payer types.
• 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.

Skills

Communication

Attention to Detail

Organizational Skills

Computer literacy

Microsoft Office

Customer Service

Knowledge of medical billing

Medical terminology

Accountability

Education

High School diploma or equivalent

Job description

Intermountain Health in Utah is seeking a Credentialing Coordinator to manage the ongoing enrollment and re-credentialing for government and commercial payers across a market. You will coordinate provider enrollment, data entry, and CAQH attestations.

The role requires attention to detail, healthcare revenue cycle experience, and strong collaboration with AR, Coding, and recruitment to resolve enrollment issues and denial trends.