Job Description
Required Education :
- Verifiable High School diploma or GED required
Required Qualifications / Skills / Experience :
2-5 years of work experience with Government payers or Enrollment coordinationAdept at problem-solving and decision-making skillsAbility to work independentlyProficient in ExcelProficient in OutlookWillingness to learnPayer Enrollment Coordinator Overview :
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 ensuring we are meeting all criteria for enrolment 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.Job Duties :
This position is responsible, under the supervision of the Manager of the Payer Enrollment Dept. to :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 the 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 to obtain signature pages and validate current general information. Interact with the field (SPM and CPM's) in regards to escalation notices.Industry : Healthcare
Estimated Start Date : 03 / 10 / 2025
Dress Code : Business Professional
Only those lawfully authorized to work in the designated country associated with the position will be considered.Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client's business needs and requirements.Benefits :
For information and details on employment benefits offered with this position, please visit here . Should you have any questions / concerns, please contact our HR Department via our secure website .
California Pay Equity :
For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here .
Rose International is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender (expression or identity), national origin, arrest and conviction records, disability, veteran status or any other characteristic protected by law. Positions located in San Francisco and Los Angeles, California will be administered in accordance with their respective Fair Chance Ordinances.
If you need assistance in completing this application, or during any phase of the application, interview, hiring, or employment process, whether due to a disability or otherwise, please contact our HR Department .
Rose International has an official agreement (ID #132522), effective June 30, 2008, with the U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services, Employment Verification Program (E-Verify). (Posting required by OCGA 13 / 10-91.).
