Provider Enrollment Coordinator Position Available In Palm Beach, Florida

Provider Enrollment Coordinator

BENDCARE, LLC

Boca Raton, FL 33431 • Hybrid work We are seeking a Full-Time Provider Enrollment Coordinator (PE) to join our team in Boca Raton, FL. The ideal candidate is responsible for preparing and submitting credentialing/enrollment applications and supporting documentation for enrolling individual physician groups with payers. The PE Coordinator follows up on the status of applications for all practitioners and payers, tracking progression on all pending and completed applications.

Essential Duties and Responsibilities:

Prepare and submit credentialing applications for clients, maintain timelines and enrollment schedules, and communicate updates to departments and medical offices. Clarify carrier information requirements and maintain a strict level of confidentiality for all matters pertaining to provider credentials. Coordinate provider credentialing data and documents needed for enrollment, contracting, and other related purposes. Work closely with medical offices and physicians to obtain missing documentation for providers pertaining to provider enrollment. Obtain required signatures and follow-up on status of application process and documentation submitted. Maintain all provider information and credentialing files via Salesforce, Teams, and CAQH including demographics for all providers and enrollments application statuses. Processes application reappointment to the payers, able to determine the contracting status such as PHO (type of PHO) delegated or not delegated and notify contracting team. Manage new client start-ups, group enrollment, special projects, and monitor and/or advise clients on licensure expirations. Follow-up on all pending applications with payers every 15- 30 days. Notify proper departments and providers of participation status with all payers as the provider becomes PAR, prepare form for EHR to be configured and send participation list as requested from the provider. Resolve issues related to provider participation, process name, address, specialty, and/or termination changes for providers with all contracted payers. Verify provider loads are completed correctly with all lines of business. Conduct training as needed regarding payer enrollment. Other duties as assigned, directed, or requested.

Qualifications and Requirements:

3+ years of experience working with credentialing and/or enrollment or at least 5 years’ experience directly related to Managed Care credentialing Knowledge of provider enrollment processes and requirements for commercial, state, and community insurance companies. CMS Federal and State Guidelines related to enrollment policies Knowledge of Salesforce is a plus Ability to interact with tact and diplomacy with individuals from a variety of backgrounds and organizational levels Ability to effectively communicate both in writing and verbally, as well as interact in a professional manner with colleagues (i.e. claim coordinators, account managers, and provider services), medical office staffing and the public Ability to work independently and make sound and timely decisions is a must Proficient in Microsoft Office products including Outlook, Teams, Word, Excel, Project Management, and PowerPoint Ability to multi-task, excellent organizational skills and planning skills required Strong analytical and problem-solving skills

Job Type:

Full-time Pay:

$45,000.00 – $50,000.00 per year

Benefits:

401(k) 401(k) matching Dental insurance Disability insurance Flexible spending account Free parking Health insurance Health savings account Life insurance Paid time off Vision insurance

Schedule:

Monday to Friday Ability to

Commute:

Boca Raton, FL 33431 (Required) Ability to

Relocate:

Boca Raton, FL 33431: Relocate before starting work (Required)

Work Location:

Hybrid remote in Boca Raton, FL 33431