Medicaid Provider Enrollment Coordinator

2 weeks ago

Franklin, Tennessee, United States EnableComp Full time
Position Overview:

The Provider Enrollment Specialist plays a crucial role in overseeing and managing the enrollment processes for healthcare professionals and facilities within the Medicaid system. This position entails the meticulous submission of both digital and paper applications while ensuring the utmost confidentiality and security of patient health information (PHI).

Key Responsibilities:
  • Gather, validate, and submit necessary documentation for the enrollment of healthcare providers with Out-of-State Medicaid payers.
  • Develop and uphold comprehensive policies and procedures tailored to each state for new provider enrollments.
  • Maintain an in-depth understanding of Out-of-State Medicaid enrollment requirements and regulations, ensuring effective communication with internal stakeholders.
  • Timely submission of re-enrollment applications to keep providers' enrollment statuses current.
  • Regularly review and ensure compliance with Out-of-State Medicaid requirements and government regulations.
  • Manage workflow to guarantee timely submissions of all payor-specific forms and documents to various health plans.
  • Maintain the integrity of provider files and document any changes, corrections, or terminations in the database.
Qualifications:
  • High School Diploma or GED required; Associate's or Bachelor's Degree preferred.
  • Minimum of 1 year of experience in the healthcare sector, particularly in billing or collections.
  • At least 1 year of experience in a client-facing or customer service role.
  • Intermediate understanding of insurance payer/provider claims processing and associated data requirements.
  • Thorough knowledge of enrollment requirements and documentation necessary for accurate application completion.
  • Familiarity with general credentials and licenses (e.g., hospital license, CLIA, DEA, NPI) is advantageous but not mandatory.
  • Combination of education and experience will be considered.
  • Proficient in basic office applications, including MS Office (Word, Excel, Outlook).
  • Regular and predictable attendance is essential.
  • Ability to perform essential duties satisfactorily, with reasonable accommodations for qualified individuals with disabilities.
Additional Considerations:
  • Adhere to EnableComp's Core Values, Vision, and Mission.
  • Demonstrated ability to meet or exceed productivity targets.
  • Maintain composure under pressure and manage stress effectively while fostering relationships with stakeholders.
  • Self-motivated and capable of working independently without direct supervision.
  • Strong written and verbal communication skills.
  • Excellent analytical and problem-solving abilities.
  • Experience working with external clients and strong customer service skills.
  • Ability to prioritize and manage multiple projects and competing priorities.
  • Must be able to remain stationary for 50% of the time and occasionally move about the office.
  • Regularly operate a computer and other office equipment.

EnableComp is an Equal Opportunity Employer M/F/D/V. We are committed to creating a diverse and inclusive workplace, free from discrimination and harassment. Our focus is on recruiting, developing, and retaining top talent in the complex claims industry, fostering a culture that promotes professional growth and development.

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