Remote Part-time Enrollment Coordinator

Day in the Life of an Enrollment Coordinator

• Receives notifications from the Clinician Onboarding Liaison (COL).
• Work closely with recruiting team during the onboarding process of new providers and provide weekly credentialing updates as to status of enrollment with payors.
• Obtain and maintain provider credentialing documents for new and existing providers, including expiring documentation.
• Provides timely and pertinent information on providers for Credentialing Committee review and approval.
• Escalates Provider Credentialing issues to the Director, as needed.
• Escalates payor issues to Director, as needed.
• Tracks, generates, and prepares applications to send to provider.
• Conducts payer research on the provider.
• Adds providers to the Credentialing report.
• Reviews returned packets for accuracy and communicates updates to the Providers.
• Review weekly exception reports from management to prioritize critical issues.
• Follows up with providers for un-returned paperwork.
• Sends updated credentials to the payer and complete payer credentialing applications for new facility locations in multiple states.
• Research state requirements prior to entry into the state and creates SOP regarding same.
• Works with Director and other key stakeholders on all new facilities including enrollment of facilities and individual locations into new markets.
• Keeps all key stakeholders informed of any challenges faced in new markets.
• Primary point of contact for withdrawal of provider's employment; receive and update and notify others, if needed.
• Generate correct payer paperwork for re-validations/begin re-credentialing process.
• Partner with COL, credentialing coordinators and other key stake holders in onboarding and enrollment providers and facilities with Medicaid, Medicare, commercial and managed care plans.
• Maintenance of provider enrollment processes and credentialing databases/websites/portals including CAQH, NPPES, Navinet, Availity, PECOS.
• Support overall Provider Enrollment Department, assist contracting department with requests as necessary and work with RCM to assist with payer issues related to credentialing.
• Meets at least monthly with health plans (more if needed) to obtain statuses of providers and to address any claims issues including holds and denials.
• Works with payors to ensure timely enrollment & active status.
• Escalates trends and issues to RCM, operations, and other key stake holders as needed.

Education and Experience requirements

• Minimum of 2 years of successful work experience in physician credentialing and/or physician enrollment.
• Experience with provider credentialing databases/websites/portals (i.e.- CAQH, NPPES and PECOS).
• Experience with Modio software preferred.
• Working knowledge of the revenue cycle process.
• Overtime may be required by Management.

Schedule

Expected hours for this role are 20 hours per week . Schedule can be flexible.

Position Benefits

• Have a daily impact on many lives .
• Excellent training if you are new to this field.
• Mileage reimbursement (if applicable) Crossroads matches the current IRS mileage reimbursement rate.
• Opportunity to save lives every day!

Benefits Package

• Calm subscription for all employees