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Credentialing Provider Enrollment Coordinator

3 months ago

Denver, United States Color Genomics Full time

The mission of the Colorado Coalition for the Homeless is to work collaboratively toward the prevention of homelessness and the creation of lasting solutions for homeless and at-risk families, children, and individuals throughout Colorado. The Coalition advocates for and provides a continuum of housing and a variety of services to improve the health, well-being, and stability of those it serves. Provider Enrollment Coordinator prepares, processes, and maintains CCH locations, staff and volunteer provider enrollments and profiles. Such as Medicare, Medicaid, DentaQuest, Colorado Access, Denver Health, CAQH, and other plans CCH has a contractual relationship. Coordinator is responsible for the updating provider information and professional documents in enrollments to insure payer credentialing approvals into plans for the locations and staff providers. Maintains Credentialing and Privileging providers’ database and Expirables to meet HRSA, FTCA, CMS, CAQH, and other third-party programs. Assist with providers’ payer credentialing applications and profiles that CCH is contracted with along with updating monthly payer information worksheets (PIWs) and active provider roster. Support with CCH site and providers revalidations in programs. Coalition Benefits Choice of HMO or PPO health insurance coverage options: full-time employees contribute only 1% of their earnings for their own HMO health coverage and no more than 4% of their earnings for coverage of eligible dependents. We’re proud to offer same-and opposite-sex domestic partner coverage. Choice of dental insurance or discount plan. Vision insurance. Flexible spending accounts for health care / dependent care / parking expenses. Free basic life and AD&D insurance coverage. Employee Assistance Program , a problem-solving resource available to you and your household members. Dollar-for-dollar retirement plan matching contributions up to 5% of earnings with 3-year vesting. Extensive paid time-off, including 9 holidays, 12 days of sick leave, and three weeks of vacation for new full-time employees in their first year. The effective date for your benefits will be the first of the month following your date of hire. Essential Job Functions Sets up meetings with providers for enrolling into CMS payer plans. Meets with providers to update NPI profiles through onboarding and revalidations. Verifies, coordinates, and monitors the preparing of provider payer applications/profiles and accompanying documents, ensuring applicant eligibility for review. Supports with CCH site applications and revalidations along with updating CMS, CAQH, and other payer enrollments for staff providers, volunteers, and locations for CCH. Utilizes and establishes CAQH practice manager database and provider profiles to optimize efficiency and perform inquiries, reports and document generations. Performs monthly OIG reports and searches database for sanctions and revisions along with reporting findings. Monthly updates and revisions to Colorado Access, Denver Health, and other payer information worksheets (PIWs). Maintains monthly provider tracker worksheets (active provider roster) and submits to Revenue Cycle, and DATA. Updates and reports CCH site credentialing worksheet with updating provider affiliations to each site. Addressed provider inquires on payer credentialing applications. Maintains termed providers’ database. supports with provider credentialing, payer programs correspondence, and desk procedures. Collaborates in preparing credentialing and payer programs audits and surveys. Aids with payer contracting in preparing reports and compiling documents for filings. Responsible for preparing reports and collecting provider data for projects and supporting other departments in such requests. Assists with payer appeals on denied or delayed provider application approvals. Constructs desk procedures and Committee revisions for credentialing and payer programs. Responsible for confidentiality of providers’ information, accuracy, and integrity of all databases and reporting. Ensures tasks are performed to completion with minimal errors and are accurate, thorough and timely. Assists with cost reporting for provider information and structured supporting reports. Coordinates and implements the payer program in Cactus with staff provider data for contracting flat files. Establishes live dashboard for enrolled staff providers for access and review for Revenue Cycle and DATA. Qualifications Summary 5+ years health care credentialing and/or provider enrollment experience. Bachelor’s degree in business administration, healthcare, or related field. Relevant work experience may substitute for advanced education. $21.67 - $26.40 an hour WHERE A CANDIDATE IS PLACED IN THE COMPENSATION RANGE DEPENDS ON TOTAL RELEVENT YEARS OF EXPERIENCE Employee must be able to perform essential job functions with or without reasonable accommodation and without posing a direct threat to safety or health of self or others. To perform this job successfully, an individual must be able to perform each essential function satisfactorily. Employee will perform job according to applied laws. The requirements listed above are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The Colorado Coalition for the Homeless is committed to delivering services, making employment-related decisions, selecting volunteers, and selecting vendors without regard to age over 40, race, sex, color, religion, creed, national origin, ancestry, disability, genetic information, marital status, sexual orientation, gender identity, gender expression, pregnancy, medical condition related to pregnancy, military status, or any other applicable status protected by law. #J-18808-Ljbffr