Enrollment Coordinator

3 weeks ago

West Long Branch, United States Allied Digestive Health Full time
Job DescriptionJob Description

Allied Digestive Health is one of the largest integrated networks of gastroenterology care centers in the nation with over 200 providers and 60 locations throughout New Jersey and New York. As a fast-growing physician-led organization, our dynamic structure encourages physician input and decision-making, while simultaneously offering operational support. Our dedicated, compassionate team of providers prioritize personalized treatment plans for patients that deliver the highest quality of care. All of our doctors are board-certified in gastroenterology and hepatology. Several of them serve as chief of gastroenterology at nearby hospitals, and a number of them have been recognized as top-quality physicians in publications, including but not limited to: Best Doctors in America and Top Doctors New Jersey, and US News Health – US News & World Report.

We are excited to announce that we are looking for a Full-Time Insurance Enrollment Coordinator at our Corporate office in West long Branch.

The Enrollment Coordinator responsibilities are:


Enrollment: Coordination and oversight of provider Enrollment requirements across all managed practices and insurers. Leverage credentialing software, Medusa. Communicate to RCM Operations Manager successes and challenges as well as participate with ongoing improvement protocols. Duties include:

  • Provider par Status (weekly).
  • Athena Enrollment worklist (weekly)
  • Athena Enrollment Dashboard (weekly)
  • Mastery of MedUSA Portal
  • MedUSA requests assistance (Provide managed practice support for MedUSA Portal)
  • Close credentialing denials by troubleshooting
  • Update Provider/Department Master List
  • Report Credentialing Status to manager (weekly)
  • Identify and resolve claim denials based on enrollment/credentialing issues

  • Managed Care: Assist in reviewing and maintenance of managed care contractual agreements loaded in Athena to ensure accuracy between allowable, expected and paid amounts. Upkeep knowledge of payor policies and changes, communicating with the RCM department of those changes, and assisting in the education of the Management Services Organization (MSO). Duties include:

    • Create and maintain carrier contractual allowable builds.
    • Monitor and communicate changes in Payer Policies
    • Assistance in building Allowable, and test Payer Mismatch tracker for accuracy

  • Onboarding Assistance: Assist in the education and onboarding of new and existing managed practices in Athena One implementation. Support in implementing projects by maintaining knowledge of standards to help reduce onboarding friction with managed practices. Act as an additional resource at the practice level and for the RCM Operations Manager by facilitating bilateral communication among onboarding stakeholders. Duties include:

    • Attend on-boarding meetings when applicable.
    • Assist in Athena Go-lives operations.
    • Create and update the new Acquisition information folders which include “RCM” and “Go Live”

  • Essential Skills:

    The Enrollment Coordinator must be extremely detail-oriented. The representative must be able to comprehend all issues and be able to articulate those issues to any involved person(s) needed to assist in their complete resolution. He/she must also possess:

    • Proficient in accounts receivable and payer enrollment-related policies
    • Basic understanding of CPT and ICD coding.
    • Basic understanding of rudimentary medical terminology.
    • Excellent judgment and decision-making.
    • Problem-solving and organizational skills.
    • Reliability, Accuracy, and Efficiency when dealing with patients or third-party payors.
    • Excellent verbal and written communication skills.
    • Ability to use good judgment in highly emotional and demanding situations.
    • Ability to react to frequent changes in duties and volume of work.
    • Excellent oral and written communication skills.
    • Ability to manage multiple tasks with ease and efficiency.
    • Ability to work independently with minimal supervision and be result-oriented.
    • Effective interpersonal skills, including the ability to promote teamwork.
    • Strong problem-solving skills.
    • Ability to ensure a high level of customer satisfaction including employees, patients, physicians, and external stakeholders.
    • Maintains confidentiality of sensitive information
    • Broad knowledge of healthcare business office practices and principles
    • Mastery of all MSO software including Microsoft Office, Outlook, Teams, MedUSA, AthenaOne, as well as web tools such as Navi Net, Availity, PEAR, etc.
    • Must have Accounts Receivable experience "Claim follow-up and Denials"

The Enrollment Coordinator must have the following qualifications and/or experience:

    • High School Diploma or GED
    • 5 years of experience in a Revenue Cycle department
    • Proficiency with Microsoft office products including Word and Excel.

We offer a competitive base salary, generous benefits, including: Medical, Dental, Vision, Life Insurance, Voluntary, Time-Off Benefits, EAP, 401K and Commuter Benefits.

Job Type: Full-time

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