What are the responsibilities and job description for the Provider Enrollment Coordinator position at Jackson Healthcare?
POSITION SUMMARY :
The Provider Enrollment Coordinator is responsible for preparing and submitting credentialing applications and supporting documentation for the purpose of enrolling individual clinicians and provider groups with payers. In this role, you will ensure the setup of the clients for electronic claims submission and electronic remittance advice. You will follow up on the status of applications for clinicians and payers and track the progress on all pending applications. The primary responsibility will be to collect and manage all credentialing documents for our providers, submit enrollment applications to insurance companies and track their progress. Coordinate on boarding documents with recruiting and hospital credentialing.
ROLES & RESPONSIBILITIES :
ESSENTIAL FUNCTIONS AND BASIC DUTIES
- Collect and manage all credentialing documents for providers payer enrollment
- Register providers with CAQH, along with managing organization linkage
- Submit enrollment applications to insurance companies and follow-up until enrollment is completed
- Keep up to date provider enrollment processes and track provider participation levels
- Complete re-credentialing for established providers as required by payers
- Enter and maintain all Provider information in the credentialing database
- Meet required turnaround times and accuracy rates
- Perform ongoing research to correct data so it does not create duplicate provider, locations, payees, and participations
- Interacts with physicians, physician office personnel, hospital personnel, insurance company personnel and patients demonstrating superior customer service
- Maximizes the use of available technologies to improve revenue cycle workflow and maximize collections
- Performs other duties as necessary or assigned
- Conducts job duties in accordance with the Corporate Values and Culture - Others First - Others before self - Wisdom - Do the wise thing - Growth - Keep getting better
QUALIFICATIONS – EDUCATION, WORK EXPERIENCE, CERTIFICATIONS :
Education / Certification :
KNOWLEDGE, SKILLS, AND ABILITIES :
