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Title

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Provider Enrollment Coordinator

Description

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We are looking for a dedicated and detail-oriented Provider Enrollment Coordinator to join our team. In this role, you will be responsible for managing the enrollment and credentialing processes for healthcare providers. You will ensure that all necessary documentation is collected, verified, and submitted to the appropriate agencies and insurance companies. The ideal candidate will have a strong understanding of healthcare regulations and compliance requirements, as well as excellent organizational and communication skills. You will work closely with providers, insurance companies, and internal teams to ensure a smooth and efficient enrollment process. This position requires a high level of accuracy and attention to detail, as well as the ability to manage multiple tasks and deadlines. If you are passionate about healthcare and have a knack for administrative tasks, we would love to hear from you.

Responsibilities

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  • Manage the provider enrollment and credentialing process.
  • Collect and verify all necessary documentation from providers.
  • Submit enrollment applications to insurance companies and regulatory agencies.
  • Maintain accurate and up-to-date records of provider credentials.
  • Communicate with providers to obtain missing or additional information.
  • Ensure compliance with all healthcare regulations and requirements.
  • Coordinate with internal teams to resolve any enrollment issues.
  • Monitor the status of enrollment applications and follow up as needed.
  • Provide regular updates to providers and management on enrollment status.
  • Assist with the development and implementation of enrollment policies and procedures.
  • Conduct periodic audits of provider credentials and enrollment records.
  • Respond to inquiries from providers and insurance companies regarding enrollment status.
  • Prepare and submit reports on enrollment activities and outcomes.
  • Assist with the training and onboarding of new providers.
  • Stay current on changes in healthcare regulations and enrollment requirements.

Requirements

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  • Bachelor's degree in healthcare administration, business, or a related field.
  • Minimum of 2 years of experience in provider enrollment or credentialing.
  • Strong understanding of healthcare regulations and compliance requirements.
  • Excellent organizational and time management skills.
  • Attention to detail and high level of accuracy.
  • Strong communication and interpersonal skills.
  • Ability to manage multiple tasks and deadlines.
  • Proficiency in Microsoft Office Suite and enrollment software.
  • Ability to work independently and as part of a team.
  • Problem-solving skills and ability to handle complex situations.
  • Knowledge of insurance company requirements and processes.
  • Experience with electronic health records (EHR) systems.
  • Ability to maintain confidentiality and handle sensitive information.
  • Strong analytical and critical thinking skills.
  • Commitment to continuous learning and professional development.

Potential interview questions

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  • Can you describe your experience with provider enrollment and credentialing?
  • How do you ensure compliance with healthcare regulations?
  • What strategies do you use to manage multiple tasks and deadlines?
  • Can you provide an example of a time when you resolved an enrollment issue?
  • How do you stay current on changes in healthcare regulations?
  • What software and tools are you proficient in for managing enrollment processes?
  • How do you handle sensitive information and maintain confidentiality?
  • Can you describe a situation where you had to communicate complex information to a provider?
  • What steps do you take to verify the accuracy of enrollment documentation?
  • How do you prioritize your tasks when managing multiple enrollment applications?
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