About us
From our beginnings in 2001, IN Compass Health was one of the first hospitalist providers in the nation. Since inception, we have recruited over 1000 providers and implemented more than 65 programs across the country, serving hundreds of patients each day.
Our founder has extensive experience in hospital-based medicine and managing physician-driven medical care in complex settings. His experience, supported with his executive leaders, offers a blending of talent few firms can match. IN Compass Health has worked for more than 20 years with hospitals, physicians and payers to design and implement effective, on-site inpatient care teams and programs.
Built on this solid foundation, IN Compass Health works with hospitals and medical staffs to develop and manage successful hospitalist programs. Serving a national client base, the company is headquartered in metro Atlanta.
THIS IS NOT A REMOTE POSITION. REQUIRES COMMUTING TO ALPHARETTA, GA M-F.
PAYER ENROLLMENT AND PROVIDER SERVICES COORDINATOR
The Payer Enrollment and Provider Services Coordinator is responsible for completing applications for enrollment on behalf of physicians and groups for MSOs, IPAs, government and commercial payers. This role will maintain and update all credentialing and billing systems with current information for all providers. This role is responsible for coordinating and maintaining all credentialing documents necessary to complete credentialing and re-credentialing. Furthermore, the Payer Enrollment and Provider Services Coordinator is responsible for auditing and data analysis for all provider credentialing records, documents and files. The Payer Enrollment and Provider Services Coordinator starts and maintains the Payer Enrollment tables in Athena , Completes EFT, ERA, EDI and pay to address updates, and maintains payor portals. Ensures all demographic and location updates for each provider for all payors are complete and accurate.
Job responsibilities include, but are not limited to:
- Completing all initial payer enrollment applications for commercial and government payers.
- Completing and maintaining all CAQH profiles for all providers
- Completing timely follow up on all payer enrollment applications
- Completing and coordinating paperwork for ERA, EDI, EFT, and other electronic channels between the organization and payers in the electronic billing system, and with enrollment services
- Payer portal access
- Ensuring that re-credentialing and revalidations are completed timely to prevent any lapse in enrollment
- The loading and timely maintenance of credentialing and billing information in the billing and Credentialing/enrollment system
- Communicating with hospitals, payers, providers, and other entities to quickly and accurately obtain or provide information beneficial to the credentialing or enrollment needs of the organization
- Maintaining knowledge of current health plan and agency requirements for credentialing
- Ensuring practice addresses are current with government and commercial health plans, agencies and other entities
- Maintaining confidentiality of provider information
- Terminating enrollment with government and commercial payers upon resignation or termination of providers
- Updating and maintaining National Provider Identification files for providers
- Using the electronic billing system, along with any of the organization’s proprietary spreadsheets or software, purchased or leased, as the primary source of immediate notification and maintenance of enrollment related data
- Responding to the enrollment services dashboard tasks and overall maintenance and content
- Communicating with Athena Health Enrollment Services as needed both verbally or through tasks and cases
- Monitoring worklists to identify increases in accounts receivable or claims denials related to enrollment and credentialing issues, and working toward resolution
Qualifications, Skills and Knowledge Required:
- Bachelor’s degree from an accredited university preferred or 3 years minimum experience in a payer enrollment related field
- Knowledge of Healthcare Billing systems (Athena preferred)
- Knowledge and thorough understanding of managed care operations including enrollment, credentialing, contracting and claims
- Knowledge of payer processes, local, state, and federal requirements
- Excellent written and oral communication skills
- Knowledge of Microsoft Office products, advanced in Excel
- Strong organizational, problem solving and decision-making skills
- Ability to prioritize and manage multiple projects and issues effectively and simultaneously
- Self-motivated and self-starter who can work well under minimal supervision
- Strong attention to detail, research and follow up skills
- Ability to work both independently and in a team setting
Keywords
- Payor Enrollment
- CAQH
- Medicare/Medicaid
- Healthcare Billing
- Insurance physician enrollment
THIS IS AN IN-OFFICE POSITION, NO REMOTE WORK AVAILABLE.
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
Schedule:
Work Location: In person