<p>Job Summary</p> <p>The Senior Enrollment Coordinator is responsible for overseeing and managing the provider payer enrollment process. This role ensures accuracy, efficiency, and compliance with policies while providing exceptional service to VPHO Network.</p> <p>Responsibilities</p> <ul> <li>Tracks, generates, and prepares applications to send to payors. </li><li>Conducts payor research on the location(s) as needed to ensure enrollments are complete and continuous without interruption in PAR status. </li><li>Adds all location payor status details into the MDStaff database including welcome letters, recredentialing/revalidation dates, PAR status and any additional notes related to the location enrollment. </li><li>Discrepancies are researched and resolved by the Senior Enrollment Coordinator and communicated to the Director and Manager </li><li>Keeps all key stakeholders informed of any challenges faced in new and existing markets. </li><li>Generates correct payor paperwork for re-validations/re-credentialing process and submits applications in advance of due dates to ensure no interruption in location PAR status. </li><li>Maintenance of provider enrollment processes and credentialing databases/websites/portals including CAQH, NPPES, Navinet, Availity, PECOS. </li><li>Support overall Provider Enrollment Department, assist contracting department with requests as necessary and work with RCM to assist with payor issues related to credentialing. </li><li>Meets at least monthly with health plans (more if needed) to obtain statuses of providers and to address any claims issues including holds and denials. </li><li>Works with payors to ensure timely enrollment & PAR status. </li><li>Regularly requests and reconciles location rosters from payors. </li><li>Escalates trends and issues to department management, RCM, operations, and other key stake holders as needed. </li><li>Serves as a resource to other team members for purposes of cross training, onboarding of new employees and subject matter expertise. </li><li>Education and Experience requirements </li><li>Minimum of 5 years of successful work experience in provider enrollment or related field with heavy emphasis on location enrollments. </li><li>Experience with commercial and government plan enrollments. </li><li>Experience with provider credentialing databases/websites/portals (i.e.- CAQH, NPPES and PECOS). </li><li>Experience with MDStaff software or other credentialing software is highly desirable. </li><li>Self-starter with strong organizational skills and a sense of urgency. </li><li>Ability to work independently and as part of a team. </li><li>Timely follow-up on open items. • Working knowledge of the revenue cycle process. </li><li>Proven ability to support multiple projects and work in stressful situations. </li><li>Ability to communicate effectively with all levels of management both written and verbal. </li><li>Overtime may be required by Management. </li></ul> <p>Education</p> <ul> <li>Bachelor's Degree </li></ul> <p>Minimum of 5 years of successful work experience in provider enrollment or related field with heavy emphasis on location enrollments.</p> <p>Work Schedule: Days</p> <p>Status: Full Time Regular 1.0</p> <p>Location: Northgate-400 Association Dr.</p> <p>Location of Job: US:WV:Charleston</p> <p>Talent Acquisition Specialist: Tamara B. Young</p>