Business and Provider Enrollment Coordinator

Business and Provider Enrollment Coordinator

Business and Provider Enrollment Coordinator

Position Status

Full Time

Department

Business Services

Location

Facility

Position Days

Hours Per Week

Weekends Required

Reports To

Contact Info

Job Description

Our Mission:  To improve lives by providing comprehensive, high-quality healthcare to every person in every community that we serve.

Our Vision: CCHN will maintain its position as the leading community health center in the state and become a model for all other healthcare organizations to follow.

At CompleteCare we are patients serving patients. We know what it’s like to be on the other side of the desk, so we are driven by the common purpose to continually exceed expectations at every turn.  

CompleteCare employees are a particularly dedicated group of individuals who are good at what they do and want to use their skills to help people. Working for the community requires diligence and efficiency, but more than anything else, CompleteCare knows that kindness is the best way to truly make a difference.

If you are someone who wants to be the change, then we want you to join our team!

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Major Function:  Responsible for coordinating, monitoring and maintaining the insurance enrollment and re-enrollment process for providers and electronic billing. Ensure that file maintenance, within practice management system is keep up to date for billing purposes. Establish and maintain a relationship with outside vendors/contractors pertaining to medical billing and provider enrollment needs.

Quality Standards:

  • Professionalism
  • Positivity
  • Productivity
  • Promptness
  • Kindness

 

Qualifications:

Associates in Arts (AA) Degree (preferred)

Knowledge of provider licensing (Lic., DEA, CDS, malpractice Ins.)

Proficient with Microsoft Office

Ability to multi-task in a fast paced environment

Excellent communication skills

Able to work as a team player as well as independently

Detail oriented

Problem solving skills

Excellent Customer Service

Ability to travel (if needed)

Flexible

 

 

Job Duties include, but not limited to:

Ensure all new providers are enrolled with every major carrier within 6 months of hire:

  • Medicaid-Medicare-Medicaid HMOs (HNJH, UHCCP, Amerigroup…) -BCBS-Aetna-AmeriHealth-AmeriHealth Administrators- Qualcare-TriCare-Cigna-Oxford- UnitedHealthCare Commercial, and third party plans (Davis, Magellan…)

Ensure all CCHN locations are attached to all major payers

Maintain grid of provider’s status with payers

Obtain and maintain CAQH and NPI provider and location profiles

Maintain/Update file maintenance as it pertain to billing:

  • Providers
  • Locations
  • Insurance Contracts
  • Encounter Rates
  • Add New Insurances
  • Add CPTs and ICD10 (as needed)

Establish and maintain a relationship with outside vendors/contractors pertaining to medical billing and provider enrollment needs.

Establish and maintain a relationship with provider relations representatives from payers

Deposit (as assigned)

Reconciliation of payments or charges (as assigned)

Help with internal and external phone calls

Miscellaneous duties (special projects assigned as needed)

 

EOE