Search Jobs
Payor Enrollment Coordinator
Plano, TX 75075-6101 | View Maps & Directions
Job Description
Select Medical Outpatient Division
3820 American Drive
Plano, Texas
(On-Site/Hybrid/Remote)
Full Time
Monday - Friday (7:30am-4:00pm - with flexibilty in shift)
Diverse Health Benefit Packages, PTO & EID Leave, 401K company match & more
We are looking for the ideal employee who will bring a strong knowledge base of NCQA and HIPAA standards for credentialing clinicians for our outpatient division. You’ll champion the Select Medical culture of teamwork, building trust, superior quality, and show the ability to own your own future. You will be an important contributor to ensure the division can maintain a high-quality network of clinicians providing quality care to our patients. You will have opportunities to experience personal and professional growth.
Responsibilities
- Manage all phases of the Non-Delegates Payor Enrollment process for providers and facilities.
- Make determinations as to why claims are rejected and partner with external sources to determine the best resolution.
- Partner with internal resources (Contracting department) to determine the payor credentialing requirements.
- Understand all payors and their requirements in order to build relationships within a specific territory so as to know what questions to ask and from whom to get resolutions.
- Review all contracting for accuracy and partner with payors to ensure the proper credentialing status.
- Complete Payor Enrollment and re-credentialing for facilities and practitioners with all applicable, contracted, Non-Delegated Payors.
- Work with CVO Coordinators for the collection of all payor enrollment requirements such as signature pages, licensure, proof of Liability, et al.
- Complete and track all health plan credentialing and enrollment for practitioners and facilites.
- Serve as a company source of information regarding the status of non-delegated payor credentialing activity.
- Maintain the credentialing database with relevant payor tracking and data.
- Monitor provider and facility status in both internal and external data systems relating to nondelegated payor enrollment.
- Maintain all payor enrollment portals such as CAQH, with current information, such as contact information, licensure effective dates and current certificate of liability data.
Qualifications
Minimum Requirements:
- Associates or Bachelor's degree OR a minimum of 2 years’ experience in the credentialing field or related healthcare field
- Proficient in Windows (Word, Excel, and Access)
- Ability to be professionally assertive with both internal and external partners to be influential in finding resolutions
- Good oral and written communication skills with the ability to interact professionally and positively within all levels of the organization
- Professional
- Organized with the ability to multi-task
- Detail orientated
- Ability to work well independently and alongside a team
Preferred Qualifications:
- Experience in payor enrollment at the medical level
- Experience working in a hospital and/or with Medicare
Additional Data
Select Medical is committed to having a workforce that reflects diversity at all levels and is an equal opportunity employer. Qualified applicants are considered for employment, and employees are treated during employment without regard to race, color, religion, national origin, citizenship, age, sex, sexual orientation, gender identity, marital status, ancestry, physical or mental disability, veteran status, or any other characteristic protected under applicable law. **
If you are interested in our Career opportunities but not ready to apply, join our Talent Network to stay connected to us and receive updates on the latest job opportunities and company now.
Join Our Talent Network