Credentialing & Enrollment Coordinator

Yoh is hiring a Credentialing and Enrollment Coordinator for our Coppell, Tx client. In this role you will be focused on performing and maintaining the enrollment and credentialing process for health insurance plans, state Medicaid entities, and Medicare for all company-owned entities. Included in these activities are the processing of Commercial and Governmental applications and re-applications, initial mailing, review, and loading into the database tracking system ensuring timing and quality standards are maintained.  They are seeing a candidate with the ability to prioritize and organize complex activities/projects and track progress as well as work effectively and collaboratively with others. The ideal candidate will possess contract administration experience, including appropriate analytical skills, attention to detail, and will be able to work independently.

Industry: Diagnostics
Location: Coppell, TX

Key Job Elements

• Securing and maintaining all health insurance plan enrollment and re-enrollment for the Company
• Perform necessary follow-up with appropriate state and federal agencies
• Completing commercial plan facility credentialing and re-credentialing forms for the Director of Managed Care
• Securing Electronic Funds Transfer form with appropriate Company authorized signature
• Create and maintain web portal registration for executed contracts
• Manage the controlled flow of contract documents through the company to secure appropriate Legal review and Executive signatures
• Maintain Commercial Contract Summary Log
• Maintain government entity Tracking log
• Maintain department files in an organized, accurate, secure manner.
• Manage incoming and outgoing departmental mail.
• Process credentialing applications/enrollments and the supporting documentation.
• Enroll entities in Medicare and revalidate information, as necessary.
• Enroll entities in State Medicaid programs and revalidate information as necessary.
• Complete commercial health plan credentialing and recredentialing documents for all entities.
• Complete credentialing and recredentialing documentations for all entities which require physician credentialing.
• Track license and certification expirations to confirm renewals.
• Maintain accurate information for entities, updating their credentials as necessary.
• Perform data entry into databases or systems.
• Responsible for health plan/government entity provider-related communications pertaining to credentialing/enrollment.
• Respond to internal and external customer inquiries regarding credentialing/enrollment status.

Knowledge/Experience

• High School diploma or equivalent
• Bachelor degree preferred
• 1 years of experience in healthcare contracting
• Hands on experience with Medicare/Medicaid
• Strong knowledge of payor and facility processes 
• Computer skills to include Word, Excel, Power Point, Outlook
• Strong interpersonal and communication skills, both written and oral, with varying levels of colleagues and/or management
• Ability to manage open projects to the end with successful follow up
• Attention to detail and strong organization skills
• Ability to work independently within guidelines and company policies
• Ability to effectively present information and respond to questions from managers, clients, and customers  

Estimated Min Rate: $28.00
Estimated Max Rate: $32.00

#IND-SPG

Note: Any pay ranges displayed are estimations.  Actual pay is determined by an applicant's experience, technical expertise, and other qualifications as listed in the job description.  All qualified applicants are welcome to apply.

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Visit https://www.yoh.com/applicants-with-disabilities to contact us if you are an individual with a disability and require accommodation in the application process.

For California applicants, qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.  All of the material job duties described in this posting are job duties for which a criminal history may have a direct, adverse, and negative relationship potentially resulting in the withdrawal of a conditional offer of employment.