Provider Enrollment Assistant

Job Description

Job Description

Reports to: Enrollment Coordinator

Job Type: Full Time, Hourly

Background: Cahaba Medical Care Foundation is a community health center providing medical, pharmacy, dental, and behavioral health services to diverse underserved communities in Jefferson, Bibb, Perry, Chilton, and Wilcox counties. We are a Level 3 Patient-Centered Medical Home and Joint Commission-accredited organization, committed to increasing integration and coordination of behavioral health and primary care. This is an exciting, fast-paced practice with a strong mission and commitment to providing high-quality care.

Purpose: The Provider Enrollment Assistant assists the Enrollment Coordinator and Provider Enrollment Specialist in ensuring that all documents are on file and health care providers are properly enrolled with payers so that claims filed for payment are not denied due to enrollment-related errors or omissions.

Responsibilities and Duties:

• Assist in preparing and submitting enrollment applications for physicians and allied health professionals, and facilities with government and third-party payers

• Assist in monitoring and coordinating activity regarding new enrollments to ensure that all providers are enrolled with all assigned payers

• Assist in the process and monitoring of hospital privilege applications

• Update the provider directory for changes received from insurers

• Troubleshoot and resolve payer issues related to enrollment/credentialing

• Maintain each provider's CAQH account (Council for Affordable Quality Healthcare) to ensure continuous accuracy

• Coordinate provider onboarding

• Act as a liaison between insurance companies, hospitals, and other facilities and parties regarding enrollment issues

• Ensure that all required insurance credentialing documentation on file is current

• Collaborate with the Enrollment Coordinator on problem-solving, continuous improvement, and issue resolution

• Maintain a detailed log/spreadsheet of all pending and completed tasks and enrollments

• Communicate enrollment status with the supervisor on a regular basis

• Assist with special projects and information requests

Attributes Required:

Work Ethic: an intrinsic drive to excel

Integrity: an indisputable reputation for honesty

Values: demonstrated passion for Cahaba Medical Care's Core Cultural Competencies Confidentiality: disciplined sensitivity regarding confidential information

Skills and Qualifications:

Required

• Attention to detail

• Ability to manage workload so that tasks and projects are completed on schedule. Effectiveness in communicating with and influencing action from providers, clinicians, and professionals in the insurance industry

• Proficiency with laptop functions, electronic spreadsheets and documents (Google Sheets and Google Docs), and internet interactions

• Affinity for both simple tasks and complex projects

Preferred

• Familiarity with enrollment and credentialing processes

• Experience in enrolling healthcare providers with various payers