Payor Enrollment Coordinator

Select Medical Outpatient Division

Payor Enrollment Coordinator

3820 American Drive

Plano, Texas 75075

Full Time (On-Site/Hybrid)

M-F 7:30am-4:00pm (some flexibility)

Diverse Health Benefit Packages, PTO & EID Leave, 401K company match & more

*Are you an individual looking to continue a career in the non-clinical side of healthcare?

* Do you have experience in payor enrollment, provider credentialing or another related healthcare field?

*Do you enjoy performing diverse tasks while working with a collaborative team in an office setting?

Then this might be an opportunity for you! 

• Manage all phases of the Non-Delegates Payor Enrollment process for providers and facilities.
• Make determinations as to why claims are rejected and partner with external sources to determine the best resolution.
• Partner with internal resources (Contracting department) to determine the payor credentialing requirements.
• Understand all payors and their requirements in order to build relationships within a specific territory so as to know what questions to ask and from whom to get resolutions.
• Review all contracting for accuracy and partner with payors to ensure the proper credentialing status.
• Complete Payor Enrollment and re-credentialing for facilities and practitioners with all applicable, contracted, Non-Delegated Payors.
• Work with CVO Coordinators for the collection of all payor enrollment requirements such as signature pages, state licenses, proof of liability, etc.
• Complete and track all health plan credentialing and enrollment for practitioners and facilites.
• Serve as a company source of information regarding the status of non-delegated payor credentialing activity.
• Maintain the credentialing database with relevant payor tracking and data.
• Monitor provider and facility status in both internal and external data systems relating to nondelegated payor enrollment.
• Maintain all payor enrollment portals such as CAQH, with current information, such as contact information, licensure effective dates and current certificate of liability data.

Minimum Requirements:

• At least 2 years experience in the credentialing field or related healthcare field.
• Proficient in Windows (Word, Excel, and Access).
• Ability to be professionally assertive with both internal and external partners to be influential in finding resolutions.
• Strong oral and written communication skills with the ability to interact professionally and positively within all levels of the organization.
• Detail oriented with good organizational skills and the ability to maintain accuracy while meeting deadlines and production requirements.
• Professional with the ability to work well independently as well as collaboratively with a team.

Preferred Qualifications:

• Experience working in a hospital and/or with Medicare.
• Experience in payor enrollment, facility enrollment and Medicare/Medicaid.
• Knowledge of credentialing processes, terminology and NCQA standards.
• Strong analytical skills, including process improvement and problem resolution.

Select Medical is committed to having a workforce that reflects diversity at all levels and is an equal opportunity employer. Qualified applicants are considered for employment, and employees are treated during employment without regard to race, color, religion, national origin, citizenship, age, sex, sexual orientation, gender identity, marital status, ancestry, physical or mental disability, veteran status, or any other characteristic protected under applicable law. **