Remote Part-time Enrollment Coordinator

Crossroads Treatment Centers • Greenville, SC

2d • Remote

About The Position

The Enrollment Coordinator supports provider and facility enrollment and credentialing across Medicaid, Medicare, commercial, and managed care plans. The role works with recruiting, the Clinician Onboarding Liaison, credentialing coordinators, the Director, Revenue Cycle Management (RCM), operations, and other stakeholders to maintain accurate provider records, complete payer applications, monitor enrollment status, and resolve credentialing-related issues. The position also supports enrollment for new facilities and locations in new markets, including researching state requirements and creating related standard operating procedures.

This is a remote, part-time role expected to work 20 hours per week, with a flexible schedule. Overtime may be required by management.

Requirements

• At least 2 years of successful work experience in physician credentialing and/or physician enrollment.
• Experience with provider credentialing databases, websites, or portals, such as CAQH, NPPES, and PECOS.
• Overtime may be required by management.

Nice To Haves

• Experience with Modio software.
• Working knowledge of the revenue cycle process.

Responsibilities

• Receive notifications from the Clinician Onboarding Liaison (COL).
• Work with recruiting during provider onboarding and provide weekly updates on provider enrollment status with payors.
• Obtain and maintain credentialing documents for new and existing providers, including documents nearing expiration.
• Provide timely and relevant provider information for Credentialing Committee review and approval.
• Escalate provider credentialing and payor issues to the Director as needed.
• Track, generate, and prepare applications to send to providers.
• Research payors for providers and add providers to the Credentialing report.
• Review returned application packets for accuracy and communicate updates to providers.
• Review weekly management exception reports and prioritize critical issues.
• Follow up with providers regarding paperwork that has not been returned.
• Send updated credentials to payors and complete payer credentialing applications for new facility locations in multiple states.
• Research state requirements before entering a state and create standard operating procedures based on those requirements.
• Work with the Director and other stakeholders on new facilities, including enrolling facilities and individual locations in new markets.
• Keep stakeholders informed of challenges in new markets.
• Serve as the primary point of contact for provider employment withdrawals, receiving and updating information and notifying others as needed.
• Generate payer paperwork for revalidations and begin re-credentialing processes.
• Partner with the COL, credentialing coordinators, and other stakeholders to enroll providers and facilities with Medicaid, Medicare, commercial, and managed care plans.
• Maintain provider enrollment processes and credentialing databases, websites, and portals, including CAQH, NPPES, Navinet, Availity, and PECOS.
• Support the Provider Enrollment Department, assist the contracting department with requests as needed, and work with RCM on payer issues related to credentialing.
• Meet with health plans at least monthly, or more often as needed, to obtain provider status updates and address claims issues, including holds and denials.
• Work with payors to ensure timely enrollment and active status.
• Escalate trends and issues to RCM, operations, and other stakeholders as needed.

Benefits

• Calm subscription for all employees.
• Mileage reimbursement, if applicable, at the current IRS mileage reimbursement rate.
• Opportunity to have a daily impact on many lives.
• Training for employees who are new to the field.

What This Job Offers

• Job Type: Part-time
• Education Level: No Education Listed