[Hiring] Enrollment Coordinator @Crossroads Treatment Centers

Role Description

As an Enrollment Coordinator, you will:

• Receive notifications from the Clinician Onboarding Liaison (COL).
• Work closely with the recruiting team during the onboarding process of new providers and provide weekly credentialing updates as to the status of enrollment with payors.
• Obtain and maintain provider credentialing documents for new and existing providers, including expiring documentation.
• Provide timely and pertinent information on providers for Credentialing Committee review and approval.
• Escalate Provider Credentialing issues to the Director, as needed.
• Escalate payor issues to the Director, as needed.
• Track, generate, and prepare applications to send to providers.
• Conduct payer research on the provider.
• Add providers to the Credentialing report.
• Review returned packets for accuracy and communicate updates to the Providers.
• Review weekly exception reports from management to prioritize critical issues.
• Follow up with providers for un-returned paperwork.
• Send 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 create SOP regarding same.
• Work with Director and other key stakeholders on all new facilities including enrollment of facilities and individual locations into new markets.
• Keep all key stakeholders informed of any challenges faced in new markets.
• Act as the 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 stakeholders in onboarding and enrollment providers and facilities with Medicaid, Medicare, commercial and managed care plans.
• Maintain 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.
• Meet at least monthly with health plans (more if needed) to obtain statuses of providers and to address any claims issues including holds and denials.
• Work with payors to ensure timely enrollment & active status.
• Escalate trends and issues to RCM, operations, and other key stakeholders as needed.

Qualifications

• 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.

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!
• Calm subscription for all employees.