What are the responsibilities and job description for the Provider Enrollment Coordinator, WI Remote position at SSM Health?
It's more than a career, it's a calling.
WI-REMOTEWorker Type:
RegularJob Highlights:
At its core, SSM Health is a healing ministry — an integrated Catholic, not-for-profit health system that serves the comprehensive health needs of communities across the Midwest. This foundation permeates our culture.
SSM Health’s leadership, physicians and providers are committed to our system's Mission: Through our exceptional health care services, we reveal the healing presence of God.
We are seeking a Provider Enrollment Coordinator to join our dedicated team in the area of Revenue Cycle and Business Office.
Location: This is a remote opportunity available to Wisconsin residents.
Office hours: You can start your day as early as 6:00 a.m. and end it no later than 6:00 p.m.
Job Summary:
Responsible for proactive enrollment of physicians and other health care practitioners for participation in government programs and with contracting commercial payers.Job Responsibilities and Requirements:
PRIMARY RESPONSIBILITIES
- Responsible for identifying denial trends and working with team to facilitate root cause analysis and continuous process improvement.
- Prepares and submits government credentialing applications and supporting documentation for the purpose of enrolling and re-enrolling individual physicians and other healthcare practitioners with Medicare, Medicaid and other government payers.
- Prepare and submit government payer re-credentialing applications as required by Medicare, Medicaid or other government payers.
- Coordinate with regional managed care staff to ensure physicians and other health care providers are enrolled timely with contracted commercial payers.
- Work claim edit work queues and add provider identification numbers to Epic to ensure claims are released for payment.
- Follow up on claims that are rejected or denied due to provider enrollment issues.
- Coordinate with medical group leaders and clinic staff on all enrollment matters, including receiving timely notification of new providers, obtaining necessary enrollment documents timely and providing feedback relating to provider issues that impede the enrollment process.
- Performs other duties as assigned.
EDUCATION
- High school diploma or equivalent
EXPERIENCE
- Three years' experience
Department:
8700010033 Sys Optimiztn Prov Enroll PB Prior AuthWork Shift:
Day Shift (United States of America)Scheduled Weekly Hours:
40Benefits:
SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs.
Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).
Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.
Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members.
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SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.
