Provider Enrollment Coordinator

SSM Health • MO-REMOTE, MO

3d • Remote

About The Position

It's more than a career, it's a calling. MO-REMOTE Worker Type: Regular Job Highlights: Play a key role behind the scenes in ensuring providers are properly credentialed and enrolled with health plans, enabling seamless access to care for patients. In this collaborative, detail-driven role, you will manage enrollment processes, maintain accurate provider data, and partner across teams to resolve issues and support operational success. If you thrive in a fast-paced environment and enjoy working across systems and teams, this is a great opportunity to make a meaningful impact. Job Summary: Responsible for proactive enrollment of physicians and other health care practitioners for participation in government programs and with contracting commercial payers.

Requirements

• High School diploma/GED or 10 years of work experience
• One year experience

Responsibilities

• Responsible for identifying denial trends and working with team to facilitate root cause analysis and continuous process improvement.
• Prepares and submits government credentialing applications and supporting documentation for the purpose of enrolling and re-enrolling individual physicians and other healthcare practitioners with Medicare, Medicaid and other government payers.
• Prepare and submit government payer re-credentialing applications as required by Medicare, Medicaid or other government payers.
• Coordinate with regional managed care staff to ensure physicians and other health care providers are enrolled timely with contracted commercial payers.
• Work claim edit work queues and add provider identification numbers to Epic to ensure claims are released for payment.
• Follow up on claims that are rejected or denied due to provider enrollment issues.
• Coordinate with medical group leaders and clinic staff on all enrollment matters, including receiving timely notification of new providers, obtaining necessary enrollment documents timely and providing feedback relating to provider issues that impede the enrollment process.
• Performs other duties as assigned.

Benefits

• Eligible team members receive one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).
• Voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.
• Upfront tuition coverage through FlexPath Funded for eligible team members.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED