Provider Enrollment Coordinator

HealthPartners is hiring for a Provider Enrollment Coordinator. The Provider Enrollment Coordinatoris responsible formanaging all aspects of provider enrollment and revalidation with federal state and commercial payers to ensuretimelyandaccurateparticipation status. This role supports the onboarding lifecycle for physicians advanced practice clinicians and other healthcare providers by coordinating documentationmonitoringapplication progress and communicating status updates to internal stakeholders and external agencies. Thecoordinatorensures compliance with organizational standards and payer-specific requirements helping to prevent revenue disruption andoptimizeoperational efficiency.

MINIMUM QUALIFICATIONS:

• Education Experience or Equivalent Combination:

• High school diploma or equivalent.

• 2 years of experience in provider enrollment medical staff services credentialing or revenue cycle operations.

• Knowledge Skills and Abilities:

  • Strong knowledge of Medicare/Medicaid enrollment processes and commercial payer requirements.

  • Excellent organizational skills and attention to detail.

  • Ability to manage multiple deadlines andshiftpriorities.

  • Strong communicationskills and comfort interacting with providers and payer representatives.

PREFERRED QUALIFICATIONS:

• Education Experience or Equivalent Combination:

  • Associate or bachelors degree in business healthcare administration orrelatedfield.

  • Experience with CAQH PECOS NPPES and common credentialing/enrollment software systems.

ESSENTIAL DUTIES:

Provider Enrollment & Payer Management 80%

• Enrollment consists of 10 entities and several outside contract entities.

• Preparesubmit and track enrollmentforinitialenrollmentapplications forMN and WIMedicareMN and WIMedicaid enrollment is basedon the contractualplanrequirement(profile add/term/change form spreadsheets and portals).

• Preparesubmitrevalidations forMN and WIMedicareMN and WIMedicaid and commercialinsuranceplans.

• Reassignproviders with Medicare Part A for our Critical Access Hospitals.

• Provider maintenanceincludingname changes terms and changeof practice locations.

• Monitor approval timelines and proactively resolve enrollment delays or discrepancies.

• Makeupdates to CAQH PECOS NPPES and our contractual payer plans; databases.

• Re-attestation of provider data every120 daysto ensuredata isaccuratefor the contractual plans.

• Enroll providers without-of-stateMedicaid based on state specific requirements.

• Add assigned plans codes in EPIC once confirmation isreceived afterthe provider is enrolled.

Onboarding Support - 10%

• Collaborate closely withrecruitment teamscredentialing andClinic Operations to ensure alignment of start dates and enrollment readiness.

• Assistproviders with completing payer-required documentation and signatures.

• Serve as an enrollment subject matter expert for leadership recruiters and clinic teams.

• Deliver a positive professional onboarding experience for providers

Data Integrity & Compliance 10%

• Ensure all enrollment processes follow federal/state regulations payer guidelines and organizational policies.

• Maintainaccuratedigital records of applications correspondence approvals and effective dates.

• Support audits quality reviews and process improvement initiatives.

ORGANIZATIONAL EXPECTATIONS:

Values

All colleagues are expected to live our values:

Excellence:We strive for the best results and always look for ways to improve.

Compassion:We care and show empathy and respect for each person.

Partnership:We are strongest when we work together and with those we serve.

Integrity:We are open and honest and we keep our commitments.

Additional Expectations:

• Complies with safety instructions observe safe work practices provides input on safety issues and promotes a safe work environment.

• Maintains regular and timely attendance.

• Protects confidentiality.

• Demonstrates participation in and support of the organizations Corporate Integrity Program by participating in compliance-related education and training and complying with the organizations policies and procedures.

• Timely completion of all mandatory education and organizational requirements (i.e. licensure/certification Employee Health and Wellness requirements annual training etc.)