Provider Enrollment Coordinator

The Provider Enrollment Coordinator will coordinate the enrollment of licensed providers with private payers, Medicaid, and Medicare in a timely manner. The coordinator will oversee the credentialing of Bowen Health staff. This position will complete provider privileges in addition to Scopes of Practice as it relates to governing body requirements.

Duties/Responsibilities

• Below are the primary duties and essential functions of an employee in this position. While not all tasks may be performed by every employee in this role, all employees are expected to perform related tasks as needed. These essential functions must be performed with or without reasonable accommodation.
• Perform provider enrollment functions, including but not limited to: CAQH online application system, NPI applications, enrollment applications for government payors such as Medicare and Medicaid, and enrollment activities for commercial payors.
• Understand and demonstrate ability to perform enrollment duties specific to each facility type: Community Mental Health Center, Federally Qualified Health Center, Psychiatric Hospital and Crisis Receiving Services, and Bowen Recovery Center.
• Track provider enrollment applications to ensure timely enrollment and linkage of providers with Payors, including keeping updated and organized files of provider panels to communicate with local leadership or other support departments.
• Resolving issues with provider enrollments and maintaining accurate documentation of the resolved issue.
• Complete CAQH re-attestation tasks for all applicable staff
• Prepare privilege applications for all licensed staff and obtain necessary signatures. Must be re-privileged every two (2) years, with accurate documentation maintained.
• Respond timely to all recredentialing and revalidation requests within the given timeframe.
• Respond timely to all outpatient offices and support departments when paneling, credentialing, or privilege issues arise.
• Complete quarterly demographic updates as requested by the payors.
• Complete timely new enrollments with payors for any new Federally Qualified Health Center's that are opened, with emphasis on government pay sources of Medicare and Medicaid.
• Other duties as assigned.

Physical Requirements

• Occupational