
Provider Engagement Coordinator
3 days ago
Job Overview
">This role is responsible for researching, resolving, and enrolling payer issues. The Provider Enrollment Specialist will work in conjunction with the Manager to identify Provider Payer Enrollment issues or denials.
">The ideal candidate will have working knowledge of specific application requirements for Centers for Medicare & Medicaid Services (CMS), State Medicaid, and all third-party payers including pre-requisites, forms required, form completion requirements, supporting documentation such as Drug Enforcement Agency Number (DEA), Curriculum Vitae (CV), and regulations.
">Key Responsibilities:
">- ">
- Perform follow-up with market locations to research and resolve payer enrollment issues">
- Perform follow-up with Centers for Medicare & Medicaid Services (CMS), and other payer via phone, email or website to resolve any Payer Enrollment issues">
- Maintain documentation and reporting regarding payer enrollments in process.">
- Rretain records related to completed CMS applications">
- Establish close working relationships with Clients, Operations, and Revenue Cycle Management team">
- Proactively obtain, track, and manage all payer revalidation dates for all assigned groups/providers as well as complete, submit, and track the required applications to maintain active enrollment and prevent deactivation">
- Maintain provider demographics in all applicable enrollment systems">
- Add providers to all applicable systems and maintain information to ensure claims are held/released based on status of enrollment">
- Perform special projects and other duties as assigned">
Requirements:
">An associate's degree (2 years) is required, and a Bachelor's degree in a related field is preferred. At least one year of provider enrollment experience is also preferred.
">Skills and Qualifications:
">The ideal candidate will possess strong oral, written, and interpersonal communication skills. Strong word processing, spreadsheet, database, and presentation software skills are also necessary. Detail orientation, analytical, decision-making, problem-solving, organizational, time management, and teamwork skills are highly valued.
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