Healthcare Payer Enrollment Coordinator

Healthcare Payer Enrollment Coordinator

The Payer Operations and Intelligence Payer Enrollment Coordinator is integral in coordinating successful payer enrollment activities for internal and external clients. This individual will establish, maintain, and communicate payer enrollment strategies, status, and tasks with clients & internal stakeholders, while further managing & reporting on the status of deliverables critical to completing payer enrollment. Furthermore, this individual will serve as a point person for continuing enrollment education & process awareness throughout the Revenue Cycle Services ("RCS") division, ensuring appropriate tools are maximized. The role is part of a tactical team that maintains a strong knowledge of the Company's complete claim, remittance, eligibility, and claim status capabilities, ensuring each is effectively deployed, maintained and supported across the RCS customer base for operational and reimbursement efficiency. Proactive monitoring of payer and industry happenings is also expected to ensure Company awareness of the ever-evolving payer enrollment landscape. Direct collaboration with Clients, Client Services, Production Operations, Marketing, payers, and Company's EDI division is expected, thus strong verbal and written communication is key.

Key responsibilities include:

• Collaborate with clients to ensure their enrollment needs are serviced.
• Representing the Payer Operations and Intelligence Team in the New Client Implementation process.
• Work with direct manager to create and disseminate a corporate enrollment document portfolio.
• Manage and administer provider enrollment for electronic claims, remittance and eligibility.
• Collaborate directly with Company's EDI division on the administration of EDI payer enrollment changes.
• Proactively assess electronic claim and remittance setup opportunities.
• Proactively assess healthcare enrollment regulations, trends, and applicable compliance items.
• Actively participate in the Company's monthly Insurance Committee meeting and other internal EDI meetings.
• Resolve enrollment support events for internal and external customers.
• Provide subject matter expertise to Client Services and Production Operations on enrollment transactions.
• Other duties, as assigned.

Education/experience:

• Bachelor degree in Healthcare, Business or equivalent experience preferred.
• Professional with excellent communication, analytical, and time management skills.
• Detail oriented with strong organizational and multi-tasking skills.
• Advanced in Microsoft Office applications.
• Ability to assess task priorities and work independently.
• Experience in the electronic enrollment landscape considered a plus.
• Experience with one of more of Quadax's revenue cycle management applications (HARP, PAS, Xpeditor) considered a plus.
• Experience with medical billing (CMS1500, UB04) considered plus.

Preferred Education:

Bachelors or better in Health Administration or related field.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.