Job description

We are seeking Payer Enrollment Coordinators for a 3+ month onsite contract role in Cumberland, RI.

In this role you will be responsible for ensuring corporate compliance with statutory requirements for Medicare, Medicaid, and Commercial enrollment for Clinics and Providers. This role will interact and work directly with new and existing Government /Commercial payers across the country. Analysis will include developing of provider and clinic level reporting ensuring we are meeting all criteria for enrollment within our compliance policy for Government /Commercial. Payer Enrollment Coordinator will interface and work directly with the Providers, and also with Payer Relations and Revenue Cycle Operations Teams (Credentialing, Accounts Receivable, Billing, and Call Center) Clinical Ops Teams and Operations Management, in order to ensure integration of all processes.

Main duties:

• Complete, maintain, and monitor applications for initial enrollment and revalidation with Government Payers and some Commercial for Clinics and Providers in order to ensure active participation in Medicare and Medicaid programs.
• Maintain working knowledge of statutory regulations for Medicare, Medicaid, and Commercial enrollment and claims submission requirements.
• Ensure timely and accurate Group/Provider enrollment applications are submitted for Medicare and Medicaid programs.
• Minimize deactivation of government applications by following quality control procedures.
• Contact Providers when revalidation notices are received in order to obtain signature pages and validate current general information.
• Receive escalated claim issues from other internal departments and coordinate contact with payer to develop solutions.

Experience: 3-5 years work experience in provider enrollment or medical billing with Medicare, Medicaid and Commercial Insurance.

Hours: Monday-Friday 8am-4:30pm

Education: Bachelors Degree in Business Administration, Marketing, Finance or similar field preferred and have 3+ years of relevant work experience.

Job Types: Full-time, Contract

Pay: $17.50 per hour

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Ability to commute/relocate:

• Cumberland, RI 02864: Reliably commute or planning to relocate before starting work (Required)

Education:

• High school or equivalent (Preferred)

Experience:

• Medicare: 3 years (Preferred)
• Medicaid: 3 years (Preferred)
• Commercial Insurance: 3 years (Preferred)
• Customer service: 3 years (Preferred)

Work Location: In person

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