Provider Enrollment Coordinator, Remote

Mass General Brigham•Somerville, MA

3d•Remote

About The Position

Responsible for the coordination and overall tracking of the provider enrollment process. This role involves reviewing and screening credentialing applications for completeness, accuracy, and compliance with various regulations and policies. The coordinator ensures primary source verification, resolves discrepancies, and monitors files for quality standards and accreditation requirements. Additionally, this position provides guidance and supervision to specialists throughout the credentialing process.

Requirements

Medical Office/Healthcare Experience: 5-7 years required
Provider Enrollment Experience: 3-5 years required
Knowledge of provider enrollment policies, processes, procedures, and documentation.
Ability to use independent judgment and to manage and impart confidential information.
Skill in establishing priorities with independent coordination of day-to-day aspects.
Ability to communicate effectively both orally and in writing.
Strong organizational and project management skills.

Nice To Haves

Associate's Degree in a Related Field of Study preferred
Bachelor's Degree in a Related Field of Study preferred

Responsibilities

Reviews and screens all credentialing applications for completeness, accuracy, and compliance with federal, state, local, and company regulations, guidelines, policies, and standards.
Ensures primary source verification and that all documents are accurate and complete relative to credentialing standards.
Problem-solves discrepancies, time gaps, and other idiosyncrasies that could adversely impact the ability to credential and enroll practitioners.
Monitors files to ensure completeness and accuracy; reviews all file documentation for compliance with quality standards, accreditation requirements, and all other relevant policies.
Reviews reports and scoring required by regulatory and accrediting agencies, policies, and standards.
Provides guidance and supervision of specialists throughout the credentialing process.