Credentialing & Provider Enrollment Coordinator

About the Company: This Maitland company is seeking an exceptional Credentialing Coordinator & Provider Enrollment who has exceptional communication skills, thrives in a fast paced environment and sees the positive in everything they do!

Type: Direct Hire

Schedule: 8:30am-5:00pm, M-F

Job Description:

  • Submit and process initial enrollment applications and re-enrollment applications to payers as assigned by leadership.
  • Maintain the accuracy of provider NPPES and CAQH accounts.
  • Populate and prepare enrollment applications for providers.
  • Responsible for following up on outstanding enrollment information and/or paperwork from providers.
  • Review provider applications for accuracy and completeness.
  • Track and following up on enrollment or re-enrollment applications with payers until provider enrollment or re-enrollment is completed.
  • Responsible for provider file maintenance with the payers, including but not limited to provider name changes, license updates, required attestations and any other payer required data.
  • Establish and maintain professional working relationships with billing staff and work as a team to resolve billing issues related to enrollment in a timely manner.
  • Assist with roster reconciliation projects with payers.
  • Demonstrate exemplary customer service to our payers, providers and other employees.
  • Communicate risk to leadership as soon as identified.
  • Proficiently use the credentialing system as instructed by leadership.
  • Maintain the credentialing database as it pertains to enrollment.

Requirements & Qualifications:

  • Have a working knowledge and two years of enrollment experience including Medicare and Medicaid experience. 
  • Knowledgeable with NPPE website and NPI accounts.
  • Skilled in computer applications including MS Word, MS Excel, database administration and scanning applications.
  • Have excellent customer service skills.
  • Have strong organizational and time management skills.
  • Ability to be flexible to change and growth.
  • Ability to work effectively in a fast paced, high volume environment.
  • Demonstrate ethical problem-solving skills.
  • Skilled in professional verbal, written and email communications.
  • High School graduate or equivalent. AS or B.S. degree in business administration or health care related field is a plus.
City/State/Zip:Maitland, Florida 32751
Job ID:9820

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