Provider Enrollment Coordinator (Onsite/In-Person) - Sante Health

NOT A REMOTE/HYBRID POSITION

A new opportunity awaits a Provider Enrollment Coordinator at Sante Health System in Fresno, CA. This position is responsible for enrollment and recertification for Medicare, MediCal and various health plans for all clients within Santé Foundation Medical Group; in addition, the Coordinator will communicate and collaborate with Santé contracting and credentialing staff for IPA, and commercial plan enrollment, credentialing and recertification.

QUALIFICATIONS

• High school diploma/GED equivalent
• Two years of administrative healthcare equivalent experience
• Knowledge of Medicare, Medi-Cal and Commercial enrollment processes
• Familiarity with CAQH
• Knowledge of hospital and IPA credentialing processes preferred

CRITICAL SUCCESS FACTORS

Success will require well-developed competencies in these areas:

• Excellent verbal and written communication
• Attention to detail and proficient follow-up skills
• Ability to multi-task in a fast-paced environment, work independently and stay on task under general supervision

ESSENTIAL DUTIES AND RESPONSIBILITIES

Under the direction of Manager, the Enrollment Coordinator will:

1. Complete and submit group and provider enrollment applications for Medicare, Medi-Cal, and other assigned government, commercial health plan contracts, and related agreements (Letters of Agreement).
2. Review information provided within provider enrollment applications and other supporting documentation for accuracy and completeness prior to submission.
3. Respond to provider and/or practice manager inquiries and/or gather information pertaining to the provider's enrollment applications.
4. Act as liaison between provider and/or practice manager and contracted health plans and government agencies.
5. Management to develop and improve workflow processes.
6. Remain current on professional standards for credentialing, such as Medicare enrollment guidelines and requirements.
7. Monitor enrollment submissions to ensure timely responses.
8. Maintain strictest confidentiality standards for all records and documentation of applicants.
9. Communicate with department manager regularly, providing updates and potential issues in a timely manner.
10. Develop a positive working relationship with internal and external personnel, providers and clients.
11. Attend meetings and educational seminars as requested or required.
12. In the spirit of teamwork, all employees are expected to follow any other job-related instructions and to perform any other job-related duties as assigned.

ABOUT SANTE HEALTH SYSTEM

Sante Health System is a Management Services Organization that serves multiple clients. "Sante" is the French word for health. Our name symbolizes our commitment to good health, progressive care, and leadership in our community.

Sante is one of the largest healthcare claims and billing management companies in Central California. The strength of Sante is the extraordinary network of physicians, health plans, and other health service providers it offers the people of our valley. Sante coordinates with physicians, health plans, hospitals, and ancillary providers to ultimately benefit the patient in a managed care environment. Sante Health System provides numerous client services such as billing, claims processing, contracting, credentialing, finance, human resources, information services, marketing/communications, physician services, practice management, provider relations, quality improvement, and utilization management.

Sante is celebrating over 25 years of dedicated service to the community. We deeply understand that we would not be successful in enhancing the quality of life of our patients without our incredible team. This is why we have created a work culture that is comprised of talented, driven, dedicated, innovative, and service-driven professionals. We provide competitive pay, excellent benefits including medical, dental, vision, and life insurance, 401k retirement plan, paid time off, and opportunities for advancement. Being part of our team is like being part of a big family. Join our team and make Sante Health System your home away from home.

ARE YOU READY TO JOIN OUR TEAM?

If you feel that you are right for this position, apply now! We look forward to meeting you!

www.santehealth.net