Payer Enrollment Coordinator III

Integrated Resources, Inc

Cumberland, RI

JOB DETAILS
JOB TYPE
Contractor
LOCATION
Cumberland, RI
POSTED
12 days ago
This position is responsible, under the supervision of the Sr. Manager of of the Payer Enrollment Dept. This role is crucial in guiding the company towards scalable solutions that delight our patients and clients, as well as enable the growth of our business. This specific position will primarily focus on behavioral health provider enrollment. The primary responsibility of the position are: Timely completion of Government, Commercial enrollment applications for behavioral health providers and groups. Develop working knowledge of behavioral health payor policies for multiple states. Consistently document work assignment progress, enrollment follow -up status, and relevant in-process tasks withing the specified systems and time frames Update and maintain all necessary government credentialing and revalidations for all providers. Interact with providers via phone or email as needed. Ability to proficiently communicate and collaborate with Regional Directors, Credentialing team, AR partners to resolve provider denials credentialing related claims issues Works with Manger of Provider Enrollment when changes are needed for the procedure manual to ensure all payor enrollment processes are documented accurate and effective. Responsible for all aspects of user online access (i.e Web portals) Attend conference calls with client and/or team meetings as requested Notes from Spotlight Call: Position Title: Enrollment Coordinator Department: Payer Enrollment Location: On-site required due to physical mail handling Key Responsibilities Submit initial and revalidation applications for providers entering Clients Handle government and commercial payer enrollment Manage mail-based documentation and workflows Ideal Candidate Profile Experience: Preferred: 12 years of experience with government payers (Medicare/Medicaid) Not required: Candidates without direct experience will be considered if they show willingness to learn Insurance experience is considered a strong transferable skill Soft Skills: Reliable and consistent attendance Willingness to work on-site Strong communication and organizational skills Interview & Logistics Interview Format: Microsoft Teams (virtual) Interview Timeline: 12 business days after resume review Rounds: Single interview round Pre-Screening: Required; candidates should note any relevant experience or lack thereof clearly Position Summary: This role is crucial in guiding the company towards scalable solutions that delight our patients and clients, as well as enable the growth of our business. This specific position will primarily focus on behavioral health provider enrollment. Duties: Timely completion of Government, Commercial enrollment applications for behavioral health providers and groups. Develop working knowledge of behavioral health payor policies for multiple states. Consistently document work assignment progress, enrollment follow -up status, and relevant in-process tasks withing the specified systems and time frames Update and maintain all necessary government credentialing and revalidations for all providers. Interact with providers via phone or email as needed. Ability to proficiently communicate and collaborate with Regional Directors, Credentialing team, AR partners to resolve provider denials credentialing related claims issues Works with Manger of Provider Enrollment when changes are needed for the procedure manual to ensure all payor enrollment processes are documented accurate and effective. Responsible for all aspects of user online access (i.e Web portals) Attend conference calls with client and/or team meetings as requested Experience: Preferred: 12 years of experience with government payers (Medicare/Medicaid) Not required: Candidates without direct experience will be considered if they show willingness to learn Insurance experience is considered a strong transferable skill Education: High school diploma or GED required, Bachelors Degree in Business Administration, Marketing, Finance or similar field preferred and have 2+ years of relevant work experience.

About the Company

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Integrated Resources, Inc