Provider Enrollment Associate-Lead
About The Position
The Provider Enrollment Associate-Lead performs the work of a Provider Enrollment Associate while providing leadership and assisting the Director in coordinating workflow for a team. The role provides the team with knowledge, expertise, and guidance to support organized, timely, and accurate credentialing that meets regulatory standards. Credentialing includes carrier forms and online applications, as well as maintaining and training staff on Apogee software. The position requires thorough application review, filing, and follow-up to support prompt payment by payors. The role also provides enrollment services to employed providers and team members in a prompt, professional, efficient, and courteous manner. It supports accurate provider data and verification, handles confidential application information, maintains enrollment files and reports, and coordinates with internal stakeholders and external vendors.
Requirements
- Associate degree or an equivalent combination of education and work experience.
- Basic computer skills.
- Excellent customer service and communication skills.
- NYS Notary Public required within one year of hire; the posting states this requirement applies effective 4/1/21 and excludes per diem employees.
Nice To Haves
- Four years of related work experience in a healthcare setting is preferred.
Responsibilities
- Plan, organize, assign, and supervise the team's day-to-day operations and facilitate workflow.
- Orient, train, coach, and evaluate team members.
- Schedule and maintain adequate staffing coverage to meet operational demands.
- Assist the manager or Director in facilitating team workflow while also performing Provider Enrollment Associate duties.
- Communicate with the Director about team members' performance and provide feedback for recognition, performance management, or coaching.
- Develop electronic processes with the manager or Director to increase efficiency.
- Monitor Apogee software setup for credentialing and implement changes to improve process efficiency.
- Provide guidance to ensure work is timely, accurate, and compliant with regulatory standards and departmental policies.
- Deliver prompt, professional, efficient, and courteous enrollment services to employed providers and team members.
- Support the accuracy of provider data and verification, and maintain files in payor enrollment software.
- Review and validate providers' professional qualifications and ensure provider applications are complete.
- Collect and submit applications and supporting documentation to contracted insurance payors in a timely manner.
- Complete and review provider applications for submission while protecting confidential information according to department policy.
- Prepare and maintain reports and summaries of enrollment activities for managers.
- Serve as the main point of contact for the Claims Clearinghouse vendor, including the Medicaid enrollment tracking process.
- Monitor communications with administration, practice managers, provider recruitment, and the hospital credentialing department.
- Monitor team workload.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
Associate degree
