What are the responsibilities and job description for the Enrollment Coordinator III position at NTT DATA?
Job Description:
We are seeking an Enrollment Coordinator III to provide administrative and operational support to network management and provider relations functions.
This role will be responsible for ensuring corporate compliance with statutory requirements for Medicare, Medicaid, and Commercial enrollment for Clinics and Providers. The successful candidate will have the ability to work well with others; collaboratively with internal and external vendors and create partnerships through effective relationship building skills.
The 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:
• Ensure 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.
• Identify and quantify trends/issues and effectively communicate them to the appropriate members of the management team along with potential impact.
• 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.
Requirements:
Preferred Requirements:
Education:
Verifiable High School diploma or GED required
We are seeking an Enrollment Coordinator III to provide administrative and operational support to network management and provider relations functions.
This role will be responsible for ensuring corporate compliance with statutory requirements for Medicare, Medicaid, and Commercial enrollment for Clinics and Providers. The successful candidate will have the ability to work well with others; collaboratively with internal and external vendors and create partnerships through effective relationship building skills.
The 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:
• Ensure 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.
• Identify and quantify trends/issues and effectively communicate them to the appropriate members of the management team along with potential impact.
• 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.
Requirements:
- 2-5 years work experience with Government payers
- 1 year of experience with provider enrollment
Preferred Requirements:
- Adept at problem solving and decision making skills
- Ability to work independently
- Proficient in Excel
- Proficient in Outlook
- Willingness to learn
Education:
Verifiable High School diploma or GED required
