Provider Enrollment Coordinator

4 hours ago

Chicago, Illinois, United States Midwest Startups Full time
Job Title: Provider Enrollment Coordinator

At Midwest Startups, we are seeking a highly organized and detail-oriented Provider Enrollment Coordinator to join our Medical Affairs team. As a key member of our team, you will be responsible for preparing, submitting, and tracking credentialing applications and supporting documentation for the purpose of enrolling providers with payers.

Key Responsibilities:
  • Ensure applicant eligibility by analyzing a provider's profile and accompanying documents.
  • Implement, coordinate, and monitor provider enrollment and credentialing process for initial and re-credentialing applications.
  • Work closely with providers to obtain missing documentation and/or signatures pertaining to enrollment.
  • Confirm receipt of requested documents, identify and respond to issues that require additional investigation and evaluation, validate discrepancies with providers, and facilitate process for payer participation.
  • Perform timely follow-ups, maintain and update database on the status of application, and report to management and providers.
  • Enter and maintain credentialing information into our credentialing database and CAQH profile.
  • Monitor documentation expiration dates and acquire current and updated documentation.
  • Respond to inquiries from other healthcare organizations, interface with internal and external credentialing issues as they arise for enrollment and contracting matters.
  • Maintain and utilize the credentialing database to optimize efficiency, perform document generation, and track and report on applicant status.
  • Assist the Medical Affairs department with special projects.
Requirements:
  • High School Diploma.
  • Two years of credentialing experience.
  • Outlook, Excel, PowerPoint, and Word proficiency.
  • Database management skills, including querying, reporting, and document generation.
  • Ability to manage and impart confidential information.
  • Independent worker.
  • Organization and time management skills.
  • Ability to multitask.
  • Previous healthcare experience.
  • Working knowledge of clinical and/or hospital operations and procedures.
  • Knowledge of Medicare, Medicaid, and commercial payer provider enrollment process.
  • Knowledge of Symplr Credentialing Software.
  • Knowledge of NCQA standards as it relates to credentialing and health plan enrollment.
  • Strong verbal and written communication skills.
  • Informational research skills.
Work Environment:

This is a 100% remote position. Full-time employment. Reports to VP, Medical Affairs or Dir, Medical Affairs Implementations.

FLSA Status: nonexempt, hourly.

The salary range for this role is $21.00 to $25.00 per hour. This information reflects the anticipated salary for this position using current national data. The final offer will be determined based on an individual's skills, experience, education, and other job-related factors permitted by law.

At Midwest Startups, we strongly value diversity and are committed to equal opportunity and non-discrimination in all policies and practices, including the area of employment. We are proud to be an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, disability, Veteran status, gender identity or expression, marital status, genetic information, or any other legally protected status.

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