- Receives notifications from the Clinician Onboarding Liaison (COL).
- Work closely with recruiting team during the onboarding process of new providers and provide weekly credentialing updates as to status of enrollment with payors.
- Obtain and maintain provider credentialing documents for new and existing providers, including expiring documentation.
- Provides timely and pertinent information on providers for Credentialing Committee review and approval.
- Escalates Provider Credentialing issues to the Director, as needed.
- Escalates payor issues to Director, as needed.
- Tracks, generates, and prepares applications to send to provider.
- Conducts payer research on the provider.
- Adds providers to the Credentialing report.
- Reviews returned packets for accuracy and communicates updates to the Providers.
- Review weekly exception reports from management to prioritize critical issues.
- Follows up with providers for un-returned paperwork.
- Sends updated credentials to the payer and complete payer credentialing applications for new facility locations in multiple states.
- Research state requirements prior to entry into the state and creates SOP regarding same.
- Works with Director and other key stakeholders on all new facilities including enrollment of facilities and individual locations into new markets.
- Keeps all key stakeholders informed of any challenges faced in new markets.
- Primary point of contact for withdrawal of provider's employment; receive and update and notify others, if needed.
- Generate correct payer paperwork for re-validations/begin re-credentialing process.
- Partner with COL, credentialing coordinators and other key stake holders in onboarding and enrollment providers and facilities with Medicaid, Medicare, commercial and managed care plans.
- Maintenance of provider enrollment processes and credentialing databases/websites/portals including CAQH, NPPES, Navinet, Availity, PECOS.
- Support overall Provider Enrollment Department, assist contracting department with requests as necessary and work with RCM to assist with payer issues related to credentialing.
- 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.
- Works with payors to ensure timely enrollment & active status.
- Escalates trends and issues to RCM, operations, and other key stake holders as needed.
- Minimum of 2 years of successful work experience in physician credentialing and/or physician enrollment.
- Experience with provider credentialing databases/websites/portals (i.e.- CAQH, NPPES and PECOS).
- Experience with Modio software preferred.
- Working knowledge of the revenue cycle process.
- Overtime may be required by Management.
- 8:00am-5:00pm
- Have a daily impact on many lives.
- Excellent training if you are new to this field.
- Mileage reimbursement (if applicable) Crossroads matches the current IRS mileage reimbursement rate.
- Opportunity to save lives every day
- Medical, Dental, and Vision Insurance
- PTO
- Variety of 401K options including a match program with no vesture period
- Annual Continuing Education Allowance (in related field)
- Life Insurance
- Short/Long Term Disability
- Paid maternity/paternity leave
- Mental Health day
- Calm subscription for all employees
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Description
Crossroads Treatment Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.Crossroads is a leading addiction treatment provider of outpatient medication-assisted treatment (MAT). We treat patients with opioid use disorder (OUD) using medications such as methadone and suboxone/ buprenorphine. We pride ourselves in supporting our patients' medical and personal recoveries from substance use disorder. Starting our fight against the opioid addiction crisis in 2005, Crossroads has remained physician led and patient focused as we've grown to 100+ clinics across nine states. As an equal opportunity employer, we celebrate diversity and are committed to an inclusive environment for all employees and patients.
Day in the Life of an Enrollment Coordinator
Expected hours for this role are 37-40 hours per week. See specific schedule requirements below.
