Provider Enrollment Coordinator II

Tasks

• Complete hospital contract enrollment and out of state medical assistance
• Coordinate monthly managed care file delivery
• Follow up on enrollment issues from monthly downloads
• Identify denial trends and perform root cause analysis
• Maintain CAQH practitioner accounts
• Maintain provider and facility records in billing systems
• Maintain third party payer enrollment requirements
• Manage National Provider Identifier updates
• Organize and maintain enrollment files with confidentiality
• Perform internal physician file audits
• Process claim edit work queues
• Process provider enrollment documents
• Provide day to day enrollment support
• Review regulatory form changes
• Submit Medicare and Medicaid credentialing applications
• Submit Medicare and Medicaid recredentialing applications
• Support new location onboarding with operations and legal
• Update Epic with provider identification numbers
• Update billing system dictionaries and reference data
• Update malpractice certificate information in CAQH
• Update payer enrollment records for Medicare Medicaid and third party payers

Perks/Benefits

• Dental insurance
• Domestic partner benefits
• Vision insurance
• Work from home

Skills/Tech-stack

CAQH | Communication | Epic | Excel | Medicaid | Medicare