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