Provider Enrollment Coordinator

Carilion Services•Roanoke, VA

10h

About The Position

The Provider Enrollment Coordinator serves as the central operational liaison between clinical departments, internal revenue cycle partners, and external payers to ensure accurate, timely, and high-quality provider enrollment and network participation. Reporting directly to the Director of Provider Enrollment, this role is responsible for coordinating complex enrollment workflows, safeguarding data integrity, and proactively identifying risks that could delay billing or reimbursement. This position requires exceptional time management, strong analytical and critical thinking skills, and a high level of precision in data oversight. The Coordinator ensures that provider demographic, specialty, panel, and payer information is complete, accurate, and aligned across systems to support compliant enrollment, clean claims processing, and optimized revenue cycle performance

Requirements

Associate degree required or relevant education and experience may be considered in lieu of degree.
3 years of experience in a healthcare setting required.
Strong time management skills with the ability to meet deadlines in a fast-paced environment.
Excellent verbal and written communication skills.
Strong attention to detail and commitment to data accuracy and integrity.
Ability to work independently while collaborating effectively with cross-functional teams.
Proficiency with computer applications, including word processing, spreadsheets, databases, and enrollment systems.
Ability to manage multiple priorities and shift focus as business needs change.
Demonstrated professionalism, discretion, and ability to handle confidential information.
Customer-focused mindset with the ability to support providers and internal stakeholders effectively.

Responsibilities

Serves as the primary operational point of contact for clinical departments, physician leaders, and internal stakeholders regarding provider enrollment coordination and network participation.
Manages end-to-end coordination of provider enrollment readiness, ensuring all required documentation, practice details, effective dates, specialties, and panel information are complete, accurate, and aligned to submission.
Oversees data control and quality assurance processes to ensure providers are accurately loaded into enrollment, credentialing, and related systems to support timely billing and reimbursement.
Partners directly with payers to coordinate enrollment requirements, resolve discrepancies, clarify participation status, and proactively address issues impacting reimbursement or network access.
Monitors enrollment timelines and prioritizes workload based on go-live dates, payer turnaround times, and operational impact, demonstrating strong time management in a deadline-driven environment.
Communicates enrollment status, risks, and barriers to the Director of Provider Enrollment by providing clear recommendations and action plans.
Conducts routine and targeted quality audits of provider data, payer participation, specialty alignment, and effective dates to ensure ongoing data accuracy and regulatory compliance.
Applies critical thinking to identify trends, root causes of delays or denials, and systemic process gaps; develops and implements solutions in collaboration with leadership.
Maintains oversight of coordination between recruitment, contracting, credentialing, revenue cycle, Medical Staff Services, onboarding, and external payers to ensure alignment and prevent downstream revenue disruption.
Develops and refines tracking tools, reporting mechanisms, and workflow controls to strengthen visibility, accountability, and performance outcomes.
Supports development, documentation, and communication of enrollment policies, procedures, and best practices to promote standardization and operational consistency.
Handles confidential provider and organizational information with professionalism, discretion, and sound judgment.