Provider Enrollment Coordinator

2 weeks ago

West Valley City, United States Intermountain Healthcare Full time
Job Description:
The Provider Enrollment Coordinator is responsible for completing and monitoring and reporting on government and/or commercial payer enrollments for both technical and professional fee claim reimbursement. Assist in minimizing provider enrollment AR by monitoring enrollment accuracy & consistency, resolving issues affecting days in enrollment.

Provider Enrollment Coordinator

Remote

9-5pm MTN time

Job Essentials

1. Responsible for ensuring timely and accurate facility, medical group, and individual government enrollments for technical and professional fee claim reimbursement.

2. Coordinates all aspects of provider enrollment with Intermountain Health's commercial and government (Medicare and Medicaid) professional fee payer contracts for an entire market. Ensures enrollment is completed timely and accurately. 3. Works in all phases of provider enrollment, re-enrollment and expirables management ensuring the timely and accurate enrollment (and recredentialing) of providers in commercial and government payers.

4. Accurate data entry of up to date expirables, practice/billing locations and other pertinent information to the payer enrollment database.

5. Participate in review, completion and/or submission of provider enrollment initial and re-enrollment applications for local and national commercial, Medicare, and Medicaid payers via payer online portals or other methods as applicable.

6. Follow up with payers via phone, website, or email requesting network participation and follow up on submitted applications.

7. Assist providers, and client personnel with completion of the application, routinely follow up with insurance carriers to monitor the status of applications and resolve issues.

8. Facilitate completion, set-up and/or re-attestations of CAQH applications.

9. Participates in enrollment progress update meetings for assigned market. Provides status information to stakeholders. Keeps detailed notes about enrollment progress in provider enrollment database and distributes information to designated department representatives and credentialing administrators.

10. Submits provider change and termination requests to all health plans in a timely manner. Informs commercial and government payers and internal Intermountain stakeholders of provider and clinic updates in assigned market.

11. Collaborates with AR to identify claim denial trends and with Coding to identify trend denials related to CPT codes and specific payer types.

12. Execute large enrollment provider/payer projects. Complete provider enrollment and related duties for organizational clinic acquisitions. Collaborates with Recruitment in the onboarding and off-boarding of providers.

Minimum Requirements

High School Diploma or Equivalent

One year experience in a healthcare revenue cycle setting.

Preferred Qualifications

One year of experience working with governments payers and/or commercial payers in a revenue service setting.

Demonstrated knowledge of working medical billing database work queues.

Physical Requirements:

Location:
Lake Park Building

Work City:
West Valley City

Work State:
Utah

Scheduled Weekly Hours:
40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$19.27 - $29.33

We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers, and for our Colorado, Montana, and Kansas based caregivers; and our commitment to diversity, equity, and inclusion.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

All positions subject to close without notice.

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