Administrative Coordinator

Provider Enrollment (Credentialing) Coordinator

Premier Medical Resources is looking for a Provider Enrollment (Credentialing) Coordinator to join our team. The Provider Enrollment (Credentialing) Coordinator is responsible for the enrollment of providers with various payers for professional services reimbursement. The Provider Enrollment (Credentialing) Coordinator reviews provider credentialing and/or recredentialing data for accuracy based on licensing requirements and various insurer payer requirements. Obtaining information from professional providers and other sources.

Essential Functions:

Onboarding:

• Issue contracts to providers based on their statuses (1099 W2 locum) and monitor their status for timely completion.
• Collaborate with Human Resources to ensure provider inquiries are resolved in a timely and effective manner.
• Conduct provider onboarding and orientation to the practice.
• Communicate updated payer enrollment information including payer provider numbers to practice operations in a timely manner while fostering working relationships and teamwork with departments vendors etc.
• Support new provider onboarding processes as related to enrollment.

Credentialing:

• Coordinate credentialing data needed for enrollment. Credentialing data includes but is not limited to the Medical Degree Drug Enforcement Administration (DEA) number and state license number Board certifications Curriculum Vitae (CV) and liability insurance.
• Complete provider payer enrollment/credentialing and recredentialing with all identified payers in a timely manner.
• Completing timely application processes based on payer specific formats.
• Resolve enrollment issues through collaboration with physicians non-physicians office staff management contracting insurers and others as identified.
• Explain and inform providers and practice/office managers of the submission requirements for credentialing and recredentialing processes.
• Ensure the importance of compliance with credentialing/recredentialing processes is expressed.
• Update on-site practice management and staff and of any changes to requirements for credentialing individual providers based on government and commercial payer credentialing processes.
• Communicate any changes regarding contracting as it relates to enrollment and operations proactively.

Administrative:

• Manage surgery assignments schedules and distribution.
• Manage contracts with providers and coordinate onboarding with HAA and PMR.
• Ensures providers remain compliant with state federal regulations and company policies and procedures.
• Maintain updated provider credentialing data acting prior to expiration completing all additions updates and deletions.
• Obtain updated provider information from various sources including provider offices state licensing boards malpractice insurance companies residency training programs etc.
• Follow up continuously on enrollment and/or recredentialing statuses until complete.
• Resolve issues as they are identified in a timely manner with primary source verification elements by interpreting analyzing and researching data.
• Implement the entire enrollment process for all providers successfully adhering to all timelines while maintaining strict confidentiality for matters pertaining to provider credentials.
• Creates develops and maintains applicable matrices and/or utilizes departmental software that supports the enrollment functions.
• Maintains systems/applications used in the enrollment processes.

Knowledge Skills and Abilities:

Knowledge and understanding of credentialing process Ability to organize and prioritize work and manage multiple priorities Excellent verbal and written communication skills including letters memos and emails Excellent attention to detail Ability to research and analyze data Ability to work independently with minimal supervision Ability to establish and maintain effective working relationships with providers management staff and contacts outside the organization

Education and Experience:

Associate Degree or 2 years of experience in lieu of education One (1) year of provider enrollment/credentialing experience

Why Work at Townsen Memorial Health?

1. Growing Health System

• Rapidly expanding across Houston with new facilities (ERs, surgery centers, specialty clinics).
• Provides opportunities for career advancement as the system grows.
• Advanced Facilities
• Modern ERs, surgical centers, and specialty clinics with up-to-date equipment and technology.
• Focus on efficient workflows and shorter wait times, which makes the work environment smoother.

At Townsen Memorial Health System, you'll be part of a growing, physician-led hospital network that values your voice, supports your career growth, and offers a collaborative environment where patient care truly comes first.