Provider Enrollment Coordinator

The Program Enrollment Coordinatorwill coordinate the enrollment of licensed providers with private payers Medicaid and Medicarein a timely credentialing of BowenHealth staff. This position will complete providerprivilegesin addition to Scopes of Practice as it relates to governing body requirements.

Duties/Responsibilities:

Below are theprimary duties and essential functions of an employee in this position. While not all tasks may be performed by every employee in this role all employees are expected to perform related tasks as needed. These essential functions must be performed with or without reasonable accommodation.

• Perform provider enrollment functions including but not limited to: CAQH online application system NPI applications enrollment applications for government payors such as Medicare and Medicaid and enrollment activities for commercial payors.
• Understand and demonstrate ability to perform enrollment duties specific to each facility type: Community Mental Health Center Federally Qualified Health Center Psychiatric Hospital and Crisis Receiving Services and Bowen Recovery Center.
• Track provider enrollment applications to ensure timely enrollment and linkage of providers with Payors including keeping updated and organized files of provider panels to communicate with local leadership or other support departments.
• Resolving issues with provider enrollments and maintaining accurate documentation of the resolved issue.
• Complete CAQH re-attestation tasks for all applicable staff
• Prepare privilege applications for all licensed staff and obtain necessary signatures. Must be re-privileged every two (2) years with accurate documentation maintained.
• Respond timely to all recredentialing and revalidation requests within the given timeframe.
• Respond timely to all outpatient offices and support departments when paneling credentialing or privilege issues arise.
• Complete quarterly demographic updates as requested by the payors.
• Complete timely new enrollments with payors for any new Federally Qualified Health Centers that are opened with emphasis on government pay sources of Medicare and Medicaid.
• Other duties as assigned.

Physical Requirements:

• Occupational Exposure Risk Classification: The normal work routine involves minimal exposure to blood body fluids or tissues.
• The normal work routine has a minimal ergonomic risk for repetitive motion impairment.
• The position may require a minimal amount of physical exertion (bending lifting twisting) in the work area.

Required Qualifications:

• Education:High School Diploma or GED.
• Experience: Prefer one (1) year of experience in a mental health setting. Previous experience working with provider enrollment preferred.
• Certificate or Professional License: Certified Professional Healthcare Quality preferred.
• Valid drivers license and active auto insurance coverage.
• Satisfactory results from criminaland driving record background checks

Promise of Equal OpportunityandFostering a Fair and Respectful Workplace:

Bowen Health is an equal opportunity employer committedto fostering an inclusivediverseand respectful withall applicable laws including the ADA and OSHA regulations and provide reasonable accommodations for qualified individuals with disabilities. Safety is a priority for all employees.

Bowen Healthprohibitsdiscrimination based on race color religion sex national origin age disability genetic information veteran status sexual orientation gender identity or other protected statuses. Bowen Health is dedicated to creating opportunities for all employees to thrive and support our mission of compassionate care.

Required Experience:

IC