Provider Enrollment Coordinator

Job Opportunity At SSM Health

It's more than a career, it's a calling.

MO-SSM Health Mission Hill

Worker Type: Regular

Job Highlights:

Qualifications: Provider enrollment and credentialing experience strongly preferred and experience with ECHO or Credential Stream software preferred.

Schedule: Full Time, Monday-Friday, Days

Location: Remote with some time onsite at SSM Health Corporate Office (St. Louis, MO) for training and meetings.

At SSM Health, we believe in providing our employees with a fulfilling career. We strive to create an environment where individuals can grow both personally and professionally. Our company values diversity, innovation, and collaboration, and we are committed to making a positive impact on the communities we serve.

Joining SSM Health means becoming part of a team that is dedicated to providing exceptional patient care and making a difference in people's lives. Our employees are passionate about what they do, and their commitment to our mission is what sets us apart.

Remote work: This position is eligible for remote work in accordance with SSM policies. Note that remote work is not permissible in some states; Human Resources should be consulted for additional information and guidance.

*Candidates to reside in the St. Louis, MO region

Job Summary:

Responsible for proactive enrollment of physicians and other health care practitioners for participation in government programs and with contracting commercial payers.

Job Responsibilities and Requirements:

PRIMARY 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.

EDUCATION

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

EXPERIENCE

• One year experience

PHYSICAL REQUIREMENTS

• Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
• Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
• Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
• Frequent keyboard use/data entry.
• Occasional bending, stooping, kneeling, squatting, twisting and gripping.
• Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
• Rare climbing.

REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS

• None

Department: 8762010033 Managed Care Contract MO/IL

Work Shift: Day Shift (United States of America)

Scheduled Weekly Hours: 40

Benefits:

• Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).
• Flexible Payment Options: our 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: we provide upfront tuition coverage through FlexPath Funded for eligible team members.

SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law.