Provider Enrollment Spec - Irvine, CA

HCA Santa Ana , CA 92701

Posted 3 months ago

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SUMMARY

The ProviderEnrollment Coordinator administers the hospital's enrollment and re-enrollmentapplication process. The Provider Enrollment Coordinator is responsible forpreparing and submitting credentialing applications and supportingdocumentation for the purpose of enrolling various hospitals with their out ofstate payers.

ESSENTIAL DUTIES ANDRESPONSIBILITIES

  • Successfully implements the entire enrollment and credentialing process for clients who request provider enrollment services. Coordinator must maintain timelines on enrollment/credentialing schedules, communicate with providers and other departments to update as needed, clarify carrier information requirements, and maintain a strict level of confidentiality for all matters pertaining to provider credentials.

  • Reviews new client packet information received to determine the enrollment issues that need to be addressed.

  • Coordinates credentialing data needed for enrollment, contracting, and other related purposes. Credentialing data includes but is not limited to the Drug Enforcement Administration (DEA) number, state license number, Board certifications, CV, malpractice insurance, and state insurance form.

  • Works closely with the facility's designated representatives to obtain missing documentation for providers pertaining to provider enrollment. Obtains required client signatures and follows up with the carriers on documentation submitted.

  • Maintains provider information via spreadsheets and provider enrollment software including demographics for all providers.

  • Responds to internal and external inquiries on routine enrollment and contract matters, as appropriate.

  • Completes EFT authorization documents to enable payment between client and carrier.

  • Monitors and advises clients on license expirations.

  • Other duties as assigned.

Salary: $18-$22 DOE

EDUCATION, TRAINING AND EXPERIENCE:

  • High School diploma or GED required.

  • 1 years of Provider Enrollment or medical billing experience is preferred.

  • Expertise in Microsoft software products including Word, Excel, and Outlook.

  • Must be detail oriented and thorough in order to ensure the complex enrollment packages are complete and correct.

  • Must be able to communicate well with a wide variety of contacts at all levels of the organization.

  • Must be able to work cohesively in a team oriented environment and be able to foster good working relationships with others both within and outside the organization.

Disclaimer:

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be an exhaustive list of responsibilities, duties and skills required.


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Provider Enrollment Spec - Irvine, CA

HCA