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TridentCare

Payor Strategy Enrollment Coordinator

Posted a day ago
$22 - $27 per hour
2-5 years experience
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AI Summary

The role involves managing practitioner and group enrollment processes while ensuring compliance with government and third-party payor regulations. The coordinator will also resolve claims issues and collaborate with internal departments to maintain necessary certifications and documentation.

ROLE:

  • Key Responsibilities:
  • Responses to verbal and written internal or external customer inquiries within policy and procedure timeline.
  • Follows policies and procedures to maintain workflow standards.
  • Audits department functions for compliance to policy and procedure, contract, and government regulations.
  • Resolves claims issues related to practitioner or group enrollment and identifies and communicates opportunities for process improvements.
  • Collaborates with the legal, compliance, tax and other departments to obtain and or ensure maintenance of certifications, licenses or other documents necessary for compliance with Government and Third Party payor credentialing and or initial or ongoing enrollment requirements.
  • Address problems as they occur.  Keep manager advised of areas of concern or compliance issues which may lead to deactivation of enrollments or inaccurate completion of responsibilities.
  • Complete all reports according to schedule.
  • Participates in projects as they are requested.
  • Performs other tasks as assigned to support the goals of the organization.
  • Completes enrollment and related applications as needed.

 

  • OTHER RESONSIBILITIES:
    • Provides staff support as requested.
    • Other Duties as assigned.
  1. Required Skills and Qualifications:
  • Strong oral, written, and interpersonal communication skills.
  • Demonstrates initiative, ability to work independently. 
  • Excellent organizational and attention to detail skills required.
  • Must be a team player and self-starter able to exercise sound judgement to handle a variety of issues.
  • Must have a high tolerance for ambiguity and the flexibility to respond quickly and appropriately to changing circumstances and priorities as necessary.
  • Able to prioritize, trouble-shoot, and problem solve. 
  • Strong Analytical skills required.
  • Must have the ability to manage multiple and competing priorities.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions While performing the duties of this job, the employee is frequently required to talk and to hear. Specific vision abilities required by this job include close vision, depth perception and ability to adjust focus. Employee must have internet access to perform job duties.

WORK ENVIRONMENT:

Standard Office Environment (Remote)

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