Provider Enrollment Coordinator

Join a team of dynamic, results oriented professionals!

Named among “The World’s Most Admired Companies" by Fortune Magazine
Named among "America's 100 Most Trustworthy Companies" by Forbes magazine
Named among “Great Places to Work" by Becker’s Hospital Review

• Career Growth Opportunities
• Convenience market on site
• Benefit Eligibility (Medical/Dental/Vision/Life) the first of the month following 30 days of employment
• 401K program (Discretionary matching funds available)
• Employee Assistance Program
• Referral Program
• Dental plans & Vision plans
• GENEROUS Personal time off
• Eight Paid Holidays per year
• Quarterly incentive plans
• Business casual dress code
• Free Parking
• Free coffee daily
• Employee of the month awards with monetary gift and parking space
• Training Programs
• Fitness Center with personal trainer on site
• Awesome Facility with terrific amenities
• Wellness programs
• Flexible work schedule

JOB DESCRIPTION OVERVIEW:

IDX/DMS Provider Enrollment Coordinator is responsible for all communication and correspondence related to affiliate provider enrollment. Maintains handling of provider numbers in AES & DMS. Maintains accuracy and production to ensure timely and efficient completion.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Review DMS Denials related to provider enrollment to determine issue and resolution needed (Super DMS Responsibilities).
• Enter provider numbers in AES from provider notification stationary by using the IDX FSC loading matrix. Maintain provider numbers on excel facility spreadsheet.
• Request group provider numbers to be loaded in AES group module.
• Prepare Missing Provider ID Report and researches Provider Enrollment comments or questions each month for each affiliate.
• Complete Refiles as required when provider enrollment information is updated.
• Prepare Claims Hold Report each month for each affiliate.
• Prepare Weekly DMS Provider Enrollment Report
• Prepare Missing Provider ID Report for all Dates of Service and greater than 5 months for Accounts Receivable Management.
• Prepare claims Hold Report for all Dates of Service and greater than 5 months for Accounts Receivable Management.
• Enter provider numbers on DMS request from DMS worklist. Places claims on hold as necessary.
• Complete Unbilled charge report for AES & Provider Edits.
• Review AES set up for new facility start-ups.
• Coordinate with Provider Enrollment on any questions or problems associated with the accurate loading of provider numbers.
• Maintain knowledge of AES and DMS related to FSC and provider number set up.
• Assist in any special project requested by management.
• Performance of other non-essential duties may be requested.

QUALIFICATIONS / EXPERIENCE:

• A minimum of one to two years of computer experience in an office environment.
• Excellent Communication Skills
• 4-5 years AR Experience dealing with multiple carriers and the provider enrollment requirements
• Position requires good command of English. Intermediate to advance level of expertise in Lotus/Excel and WordPerfect/Microsoft Word software programs, preferably using Windows.
• Familiar with designing and maintaining worksheets. Clerical experience in filing and telephone skills. Excellent organizational skills which would have been required and demonstrated in former positions.
• Must use good judgment and reasoning skills.
• Must be flexible and independent.

SUPERVISORY RESPONSIBILITIES:

• None

PHYSICAL / ENVIRONMENTAL DEMANDS:

• This job should be performed in a well-lighted, well-vented and temperature-controlled modern office setting.
• Requires being able to deal with management team, as well as, other interdepartmental companies.
• Always present yourself in a professional manner.
• Requires constant sitting tolerance.
• Must be flexible, independent and able to meet deadlines. Jobs performed need little or no supervision.

DISCLAIMER:

Cooperative, positive, courteous and professional behavior and conduct is an essential function of every position. All employees must be able to work with others beyond giving and receiving instructions. This includes getting along with co-workers, peers and management without exhibiting behavior extremes. Job functions may require personal leadership skills such as conflict resolution, negotiating, instructing, persuading, speaking with others as well as responding appropriately to job performance feedback from the supervisor. Additionally, the information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position.