Enrollment Coordinator
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Job Summary:
This position serves as the primary point of contact for physician enrollment services provided to Medical Service Groups (MSGs) at Upstate University Medical Associates at Syracuse, Inc. (UUMAS). The role is responsible for coordinating enrollment activities with various insurance carriers as well as internal administrative staff, ensuring efficient and timely processing.
The position maintains databases by accurately updating and managing pertinent provider information to support enrollment and ongoing participation with health plans.
Coordinates and actively manages the enrollment of physicians, advanced practice providers (APPs), and other clinicians into participating health insurance plans. Maintains accurate and up-to-date enrollment data, including comprehensive records and historical documentation for all enrolled providers.
Prepares and submits enrollment and re-enrollment applicationseither electronically or in paper formensuring all required documentation is complete and aligned with client and payer requirements. Coordinates provider enrollment in delegated health plans through UUMAS and supports client-directed participation or non-participation strategies with specific insurance carriers.
Communicates enrollment status updatesincluding approvals, denials, assigned provider identification numbers, and effective datesto physicians, client management, and billing departments in a timely manner. Notifies insurance plans of changes in provider status, such as terminations, retirements, or changes in professional liability coverage.
Responds to correspondence from insurance carriers, including emails, faxes, and phone inquiries, and triages and distributes information appropriately to clients. Facilitates ongoing communication between clients and insurance companies to resolve issues related to provider enrollment and claims processing.
Generates and provides reports, as needed, detailing current provider participation status across insurance plans. Performs additional duties and special projects as assigned.
Minimum Qualifications:
Associates Degree or pertinent college level courses and three years of progressively responsible experience required. At least two years experience in a medical environment or health insurance office required. Will consider equivalent combination of education and experience.
Preferred Qualifications:
Knowledge of provider enrollment, CAQH, Delegated Credentialing
Work Days:
Monday - Friday daytime hours; No weekends
Message to Applicants:
Our benefits package includes health, dental and vision insurance, eligibility for employer 401k funding after 1 year (3% quarterly/5% annual on vesting schedule), tuition reimbursement, generous paid time off, including vacation and personal time, paid sick leave, holidays and floating holidays
G5: $21.07 - $35.22
Please note the salary information shown is a general guideline only. Salaries are based upon candidate skills, experience, and qualifications, as well as internal equity, market and business considerations.
Recruitment Office: MedBest Medical Management