Provider Enrollment Coordinator

Carilion Clinic•Roanoke, VA

2d•Onsite

About The Position

The Provider Enrollment Coordinator supports provider and facility enrollment across commercial and government payers, including revalidations, enrollment updates, and ongoing data management. The role is a primary point of contact for providers, clinical leadership, and internal stakeholders, using independent judgment, proactive problem-solving, and coordination to support timely reimbursement and revenue integrity. The coordinator maintains enrollment data integrity, monitors enrollment quality, manages Revenue Cycle Management (RCM) workqueues, coordinates projects, and resolves operational issues. This position reports to the Director of Provider Enrollment and collaborates with internal departments and payer partners on operational improvements, quality oversight, and strategic initiatives. The coordinator serves as a primary contact for new providers and clinical leadership across Carilion Clinic locations. They collect and review provider practice information forms, coordinate enrollment requirements across internal teams and external payers, monitor enrollment progress, and communicate status, issues, and urgent needs to physician and department leaders. The role ensures providers are accurately recorded in enrollment and credentialing systems and maintains accurate data across provider panels, specialties, effective dates, payer networks, and directories. It also includes auditing enrollment activity, identifying process gaps and risks, recommending improvements, and helping develop and communicate enrollment policies and best practices. The coordinator monitors, manages, and reconciles RCM workqueues to resolve enrollment-related claim holds, denials, and data discrepancies. They coordinate and track projects, operational issues, and escalations with internal departments and external payer partners to improve workflows, resolve issues promptly, mitigate risks, and protect revenue integrity.

Requirements

Associate degree, or two years of experience may be considered in lieu of a degree.
Three years of experience in a healthcare setting required.
Strong time management skills and ability to meet deadlines in a fast-paced environment.
Excellent verbal and written communication skills.
Attention to detail and commitment to data accuracy and integrity.
Ability to work independently and collaborate effectively with cross-functional teams.
Proficiency with computer applications.
Ability to manage multiple priorities and shift focus as business needs change.
Professionalism, discretion, and ability to handle confidential information.
Customer-focused mindset and ability to support providers and internal stakeholders effectively.
No licensure, certification, or registration required.

Responsibilities

Serve as a primary point of contact for new providers and clinical leadership across Carilion Clinic locations.
Collect provider practice information forms, review submissions for completeness and accuracy, and route them to enrollment teams in a timely manner.
Coordinate enrollment requirements with recruitment, contracting, credentialing, revenue cycle, Medical Staff Services, CCVS, onboarding teams, and external payers.
Monitor provider enrollment progress and communicate status, issues, and urgent needs to department Chairs, Chiefs, Directors, Managers, and physician leaders.
Ensure providers are accurately loaded into enrollment and credentialing systems to support timely billing and reimbursement.
Maintain data integrity across provider panels, specialties, effective dates, payer networks, and provider directories.
Conduct quality audits of enrollment activity and share results with leadership to support accountability and performance improvement.
Identify enrollment process gaps or risks and recommend process improvements to leadership.
Collaborate with leadership to develop, implement, and communicate enrollment policies, procedures, and best practices.
Monitor, manage, and reconcile RCM workqueues to identify and resolve provider enrollment-related claim holds, denials, and data discrepancies.
Collaborate with Revenue Cycle and payer partners to mitigate reimbursement delays and protect revenue integrity.
Coordinate and track Provider Enrollment projects, operational issues, and escalations with internal departments and external payer partners.
Drive timely resolution of issues, improve workflows, and mitigate operational and financial risks.