Enrollment Coordinator III

Enrollment Coordinator III

Type : Temporary, Long Term (not a Direct Hire position)

Location : 200 Highland Corporate Drive, Cumberland, RI 02864. It will be in office 4 days a week, and once trained there is an option to work from home on Fridays.

Start : 3 / 10 / 25

Rate : $19.27 hour W2

Positions Summary :

Provides administrative and operational support to network management and provider relations functions. Assists with contract management, data analysis, provider directory maintenance, coordination of provider communication and education, and support of the resolution of operational issues. Maintains accurate provider information, facilitating effective communication and ensuring smooth operations within the network management and provider relations

The Payer Enrollment Coordinator will be responsible for ensuring corporate compliance with statutory requirements for Medicare, Medicaid, and Commercial enrollment for Clinics and Providers. This Individual will have the ability to work well with others; collaboratively with internal and external vendors and create partnerships through effective relationship building skills. This role will interact and work directly with new and existing Government / Commercial payers across the country. Analysis will include developing of provider and clinic level reporting insuring we are meeting all criteria for enrollment within our compliance policy for Government / Commercial. Payer Enrollment Coordinator will interface and work directly with the Providers, and also with Payer Relations and Revenue Cycle Operations Teams (Credentialing, Accounts Receivable, Billing, and Call Center) Clinical Ops Teams, and MinuteClinic Field and Operations Management, in order to ensure integration of all processes.

Duties :

This position is responsible, under the supervision of the Manager of the Payer Enrollment Department :

• Ensuring timely and accurate processing of Payer Enrollment applications (Initial and Revalidations) for Clinics and Providers.
• Provide quality control for timely and accurate individual enrollment applications submitted for Medicare and Medicaid programs.
• Resolve claims issues for individual payers in corporate billing system.
• Researching, completing and maintaining compliance with individual Government payers through credentialing, re-credentialing and audit processes and procedures.
• Contact Providers when Revalidation notices are received in order to obtain signature pages and validate current general information. Interact with the field (SPM and CPM's) in regards to escalation notices.
• The Payer Enrollment Coordinator will be responsible for identifying and quantifying trends / issues and then effectively communicating them to the appropriate members of the management team along with what the potential impact could be.
• Minimize denials and deactivation of government applications where applicable to reduce key metrics including DSO, cost to collect, percent of aged claims, and Bad Debt.
• Update Credentialing and Billing systems with Provider information upon inquiry or receipt from Government / Commercial payers.

Job Requirements :

Preferred Job Requirements :

Education :

Verifiable High School diploma or GED required

About NTT Data :

NTT DATA is a recognized leader in IT and business services, including cloud, data and applications, headquartered in Texas. As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. We are committed to our clients' long-term success. Visit nttdata.com or LinkedIn to learn more.

NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.

Salary : $19