Enrollment Coordinator

Enrollment Coordinator

Location: Philadelphia, PA (Onsite)
Schedule: Monday - Friday, 8:00 AM - 5:00 PM
Duration: 3-Month Contract (Strong possibility of extension)

About the Role

We are seeking an Enrollment Coordinator to support provider enrollment, credentialing, and compliance activities for a large healthcare organization. This role is responsible for gathering, verifying, and maintaining healthcare practitioner information while ensuring all enrollment and re-credentialing requirements are completed accurately and on time.

The ideal candidate will have experience with provider enrollment, insurance verification, billing support, or provider relations, along with knowledge of Medicare, Medicaid, and healthcare payer processes.

Responsibilities

• Review and prepare provider enrollment and re-credentialing applications for accuracy, completeness, and timely submission to payers.
• Verify required licensing, certification, ownership, and provider documentation to support enrollment and credentialing activities.
• Follow up with physicians and providers to obtain missing documentation and ensure timely completion of applications.
• Maintain accurate provider records, including service locations, rendering provider information, licensure, and ownership data.
• Monitor credential and license expiration dates and send renewal reminders at least 30 days prior to expiration.
• Maintain accurate provider information within CAQH, NPPES, and internal databases.
• Complete CAQH re-attestations every 120 days as required.
• Track enrollment applications and communicate with payers regarding application status, participation dates, and provider numbers.
• Generate correspondence, emails, and phone outreach to payers and providers to facilitate timely enrollment processing.
• Document all payer communications and maintain records for compliance and audit purposes.
• Research enrollment and payer-related issues and provide support to the Billing Department for claim resolution.
• Scan, maintain, and organize credentialing and enrollment files in accordance with departmental standards.

Minimum Qualifications

• High School Diploma or GED required.
• Associate Degree preferred.
• Minimum of 2 years of experience in:
  • Provider enrollment,
  • Provider relations,
  • Medical insurance verification,
  • Healthcare billing, or
  • Credentialing-related functions.
• Working knowledge of insurance billing and provider operations within a healthcare environment.
• Knowledge of Medicare and Medicaid policies and procedures.
• Experience using CAQH, NPPES, ECHO, and/or NaviNet systems.
• Proficiency with Microsoft Office Suite, including Word, Excel, PowerPoint, and Outlook.
• Strong analytical, organizational, and problem-solving skills.
• Excellent verbal and written communication skills.
• Ability to work collaboratively with physicians, payers, billing teams, and other stakeholders.

Preferred Qualifications

• Associate Degree in Healthcare Administration, Business Administration, or a related field.
• Previous experience supporting provider enrollment or credentialing within a large healthcare organization.
• Experience managing multiple payer enrollments and provider records simultaneously.
• Familiarity with healthcare compliance and credentialing requirements.