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Part-time Enrollment Coordinator
Crossroads. Receive notifications from the Clinician Onboarding Liaison (COL) .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in physician credentialing and enrollment processes, including managing provider documentation and maintaining compliance with payor requirements. Proficient in utilizing credentialing databases and collaborating with stakeholders to ensure timely enrollment and address issues.
Highest-signal resume keywords
Physician CredentialingProvider EnrollmentCAQH Database ManagementRevenue Cycle KnowledgeModio Software Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Credentialing Document ManagementPayer ResearchApplication PreparationException Report ReviewProvider Status Communication
Soft Skills
Stakeholder CommunicationProblem-SolvingAttention to Detail
Tools & Technologies
NPPESPECOSNavinetAvailityCredentialing Databases
Industry Keywords
MedicaidMedicareCommercial PlansManaged CareSOP Development
About the role
Key responsibilities & impact- Receive notifications from the Clinician Onboarding Liaison (COL)
- Work closely with the recruiting team during onboarding of new providers and provide weekly credentialing updates on enrollment status with payors
- Obtain and maintain credentialing documents for new and existing providers, including expiring documentation
- Provide information on providers for Credentialing Committee review and approval
- Escalate provider credentialing and payor issues to the Director as needed
- Track, generate, and prepare applications for providers
- Conduct payer research and add providers to the Credentialing report
- Review returned packets for accuracy and communicate updates to providers
- Review weekly exception reports and prioritize critical issues
- Follow up with providers regarding unreturned paperwork
- Send updated credentials to payers and complete payer credentialing applications for new facility locations in multiple states
- Research state requirements and create SOPs
- Support new facility enrollment and individual location enrollment in new markets
- Keep stakeholders informed of challenges in new markets
- Manage provider employment withdrawals and notifications
- Generate payer paperwork for revalidations and begin re-credentialing processes
- Partner with COL, credentialing coordinators, and stakeholders to enroll providers and facilities with Medicaid, Medicare, commercial, and managed care plans
- Meet with health plans to obtain provider statuses and address claims issues, including holds and denials
- Work with payors to ensure timely enrollment and active status
- Escalate trends and issues to RCM, operations, and other stakeholders
- Maintain provider enrollment processes and credentialing databases/websites/portals including CAQH, NPPES, Navinet, Availity, and PECOS
- Support the Provider Enrollment Department, assist the contracting department, and work with RCM on payer issues related to credentialing
Requirements
What you’ll need- 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
- Expected hours are 20 hours per week
Benefits
Comp & perks- Flexible schedule
- Excellent training if you are new to this field
- Mileage reimbursement (if applicable); Crossroads matches the current IRS mileage reimbursement rate
- Calm subscription for all employees