Business & Provider Enrollment Coordinator
hace 9 días
Bridgeton
Job DescriptionDescription: Reporting/Department Head: Claudia Villalpando (Finance) *FLSA Status – Non-Exempt *EEO Category – Administrative Our Mission: “To improve lives by providing comprehensive, high-quality healthcare to every person in every community that we serve.” Our Vision: CCHN will maintain its position as the leading community health center in the state and become a model for all other healthcare organizations to follow. Major Function: Responsible for coordinating, monitoring, and maintaining the insurance enrollment and re- enrollment process for providers and electronic billing. Ensure that file maintenance, within practice management system is keep up to date for billing purposes. Establish and maintain a relationship with outside vendors/contractors pertaining to medical billing and provider enrollment needs. Job Duties include, but not limited to (subject to change): • Ensure all new providers are enrolled with every major carrier within 6 months of hire, • Medicaid-Medicare-Medicaid HMOs (HNJH, UHCCP, Amerigroup…) -BCBS-Aetna-, • AmeriHealth-AmeriHealth Administrators- Qualcare-TriCare-Cigna-Oxford- UnitedHealthCare Commercial, and third-party plans (Davis, Magellan…), • Ensure all CCHN locations are attached to all major payers, • Maintain grid of provider’s status with payers, • Obtain and maintain CAQH and NPI provider and location profiles, • Maintain/Update file maintenance as it pertains to billing, • Providers, • Locations, • Insurance Contracts, • Encounter Rates, • Add New Insurances, • Add CPTs and ICD10 (as needed), • Establish and maintain a relationship with outside vendors/contractors pertaining to medical, • billing and provider enrollment needs., • Establish and maintain a relationship with provider relations representatives from payers, • Deposit (as assigned), • Reconciliation of payments or charges (as assigned), • Help Business associates with A/R management (as assigned), • Help with internal and external phone calls, • Miscellaneous duties (special projects assigned as needed) CompleteCare offers full-time and part-time employees a variety of generous benefits, including but not limited to: • Comprehensive medical, dental, and vision insurance, • Paid time off (vacation, sick leave, and holidays), • 401(k) retirement plan with employer matching, • Incentive program, • Life and disability insurance, • Continuing education and professional development opportunities, • Flexible Spending Accounts (FSA), • Tuition reimbursement, • Reimbursement for licensure and certifications, • Reimbursement for CPR, • Discounted services, • Employee recognition programs, • Health Reimbursement Arrangement (HRA) via Ameriflex (covers most out-of-pocket expenses), • Pension plan, • Cancer insurance policies, • Employee-paid life insurance — 2x annual salary, up to $150K (CCHN-paid benefit), • AAA membership (discounted rates), • BJ’s Wholesale Club membership (discounted rates), • Direct deposit, • Childcare reimbursement program, • Intersite travel reimbursement The above job description is not to be construed as a complete listing of the assignments that may be given to any employee, nor are such assignments restricted to those precisely listed in the description. EOE Requirements: Qualifications: • Associates in Arts (AA) Degree (preferred), • Knowledge of provider licensing (Lic., DEA, CDS, malpractice Ins.), • Proficient with Microsoft Office Other skills/qualifications: • Ability to multi-task in a fast-paced environment, • Excellent communication skills, • Able to work as a team player as well as independently, • Detail oriented, • Problem solving skills, • Excellent Customer Service, • Ability to travel (if needed), • Ability to sit for long periods of time, • Flexible The above job description is not to be construed as a complete listing of the assignments that may be given to any employee, nor are such assignments restricted to those precisely listed in the description.