Coordinator

Coordinator

  Not Disclosed

  Cumberland, RI

  6.0 Months

  Not Disclosed

  Not Disclosed

  Pharmaceutical

  $14.37/hour - $16.37/hour

Job Description

POSITION SUMMARY:



This position is responsible, under the supervision of the Manager of the Payer Enrollment Dept. to:



Ensuring timely and accurate processing of Payer Enrollment applications (Initial and Revalidations) for Clinics and Providers.
Provide quality control for timely and accurate individual enrollment applications submitted for Medicare and Medicaid programs.
Resolve claims issues for individual payers in corporate billing system.
Researching, completing and maintaining compliance with individual Government payers through credentialing, re-credentialing and audit processes and procedures.
Contact Providers when Revalidation notices are received in order to obtain signature pages and validate current general information. Interact with the field (SPM and CPM’s) in regards to escalation notices.
The Payer Enrollment Coordinator will be responsible for identifying and quantifying trends/issues and then effectively communicating them to the appropriate members of the management team along with what the potential impact could be.
Minimize denials and deactivation of government applications where applicable to reduce key metrics including DSO, cost to collect, percent of aged claims, and Bad Debt.
Update Credentialing and Billing systems with Provider information upon inquiry or receipt from Government /Commercial payers.
The Payer Enrollment Coordinator will be responsible for ensuring corporate compliance with statutory requirements for Medicare, Medicaid, and Commercial enrollment for Clinics and Providers. This Individual will have the ability to work well with others; collaboratively with internal and external vendors and create partnerships through effective relationship building skills. This role will interact and work directly with new and existing Government /Commercial payers across the country. Analysis will include developing of provider and clinic level reporting insuring we are meeting all criteria for enrollment within our compliance policy for Government /Commercial. Payer Enrollment Coordinator will interface and work directly with the Providers, and also with Payer Relations and Revenue Cycle Operations Teams (Credentialing, Accounts Receivable, Billing, and Call Center) Clinical Ops Teams, and Field and Operations Management, in order to ensure integration of all processes.



Experience:

2-5 years’ work experience with Government payers
Adept at problem solving and decision-making skills
Ability to work independently
Proficient in Excel
Proficient in Outlook
Willingness to learn



Position Summary

Provides administrative and operational support to network management and provider relations functions. Assists with contract management, data analysis, provider directory maintenance, coordination of provider communication and education, and support of the resolution of operational issues. Maintains accurate provider information, facilitating effective communication and ensuring smooth operations within the network management and provider relations department.



Education:

Verifiable High School diploma or GED required





Note:



Mon - Fri 7:30am - 4:00pm

Onsite as needed.

It will be in office 4 days a week, and once trained there is an option to work from home on Fridays.
VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.