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Crossroads Treatment Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Since 2005, Crossroads has been at the forefront of treating patients with opioid use disorder, providing accessible, high-quality, evidence-based medication-assisted treatment (MAT) options.
Provider Enrollment Coordinator
Location
United States
Posted
48 days ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
Provider Enrollment Coordinator
Crossroads Treatment Centers
Role Description As a Provider Enrollment Coordinator, you will: - Receive notifications from the Clinician Onboarding Liaison (COL). - Work closely with the recruiting team during the onboarding process of new providers and provide weekly credentialing updates as to the status of enrollment with payors. - Obtain and maintain provider credentialing documents for new and existing providers, including expiring documentation. - Provide timely and pertinent information on providers for Credentialing Committee review and approval. - Escalate Provider Credentialing issues to the Director, as needed. - Escalate payor issues to the Director, as needed. - Track, generate, and prepare applications to send to providers. - Conduct payer research on the provider. - Add providers to the Credentialing report. - Review returned packets for accuracy and communicate updates to the Providers. - Review weekly exception reports from management to prioritize critical issues. - Follow up with providers for un-returned paperwork. - Send updated credentials to the payer and complete payer credentialing applications for new facility locations in multiple states. - Research state requirements prior to entry into the state and create SOP regarding same. - Work with the Director and other key stakeholders on all new facilities including enrollment of facilities and individual locations into new markets. - Keep all key stakeholders informed of any challenges faced in new markets. - Act as the primary point of contact for withdrawal of provider's employment; receive and update and notify others, if needed. - Generate correct payer paperwork for re-validations/begin re-credentialing process. - Partner with COL, credentialing coordinators, and other key stakeholders in onboarding and enrollment of providers and facilities with Medicaid, Medicare, commercial, and managed care plans. - Maintain provider enrollment processes and credentialing databases/websites/portals including CAQH, NPPES, Navinet, Availity, PECOS. - Support overall Provider Enrollment Department, assist contracting department with requests as necessary, and work with RCM to assist with payer issues related to credentialing. - Meet at least monthly with health plans (more if needed) to obtain statuses of providers and to address any claims issues including holds and denials. - Work with payors to ensure timely enrollment & active status. - Escalate trends and issues to RCM, operations, and other key stakeholders as needed. Qualifications - 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. Requirements - Overtime may be required by Management. - Expected hours for this role are 37-40 hours per week. - Schedule: 8:00am-5:00pm. Benefits - Have a daily impact on many lives. - Excellent training if you are new to this field. - Mileage reimbursement (if applicable) - Crossroads matches the current IRS mileage reimbursement rate. - Opportunity to save lives every day! Company Description Crossroads Treatment Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Since 2005, Crossroads has been at the forefront of treating patients with opioid use disorder, providing accessible, high-quality, evidence-based medication-assisted treatment (MAT) options.
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