Pennsylvania Licensed Provider Enrollment Coordinator

Job Summary

To ensure timely and compliant enrollment of providers and facilities with various payers, the full-time Pennsylvania Licensed Provider Enrollment Coordinator will manage the enrollment process, maintain understanding of insurance requirements, and provide support for credentialing applications while working remotely.

Key responsibilities:

• Prepare and submit government credentialing applications for enrolling and re-enrolling healthcare practitioners with Medicare, Medicaid, and other payers
• Coordinate with regional managed care staff to ensure timely enrollment of providers with contracted commercial payers
• Identify denial trends and collaborate with teams to facilitate root cause analysis and process improvements

Required qualifications:

• High School Diploma or Equivalent (GED) required
• Minimum of 3 years of related work experience required
• Understanding of third-party payer requirements and enrollment processes
• Experience with maintaining compliance with state and federal regulations
• Knowledge of billing systems and technical resources related to enrollment