Payer Enrollment Coordinator

Job Description

Job Description

Payer Enrollment Coordinator

Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare organization, passionately dedicated to improving the health and well-being of our community. With a history dating back to 1898, LMHS remains a cornerstone of healthcare excellence, catering to the evolving needs of Licking County. Our cutting-edge facility provides a comprehensive spectrum of patient care services, from life-saving emergency medicine to the comforting embrace of home healthcare, with a unique range of specialized medical services, including cancer, heart health, maternity, and mental wellness.

When you join the LMHS team, you become a vital part of your local community Hospital. Working at LMHS is not just a job, it is a unique opportunity to directly impact the health and well-being of your friends, family, and neighbors. You will be providing care in a place in which you are personally connected, where the impact of your work extends beyond the Hospital doors and into the heart of our community. Our commitment to diversity, equity, and inclusion ensures that every member of our community is served with respect and compassion. Join us in our mission – dedicated to patient safety, utilizing state-of-the-art technology, and with a passionate team of highly trained and compassionate individuals who strive to improve the health of the community.

Position Summary

The Payer Enrollment Coordinator manages payer enrollment for Licking Memorial Health Professionals (LMHP) and contracted staff providers. This role works closely with insurance companies ensuring providers are authorized to bill and receive reimbursement adhering to regulatory processes. This position is 100% in office.

Responsibilities

• Provider Enrollment and Credentialing: Ensures providers are properly enrolled and credentialed with Medicare, Medicaid, and commercial insurance payers. This includes submitting applications, managing CAQH profiles, and monitoring enrollment status.
• Communication and Coordination: Serving as a liaison between providers, insurance payers, and internal departments to resolve enrollment issues and update billing information.
• Compliance and Documentation: Maintaining accurate provider records, tracking deadlines, and ensuring adherence to regulatory and payer guidelines.
• Payer Portal Management: Managing access to and security of online payer portals, including updating provider demographic information.
• Data Management: Maintaining accurate provider information in credentialing databases.

Qualifications

• Experience with payer enrollment and CAQH preferred.
• Analytical ability to detect and resolve problems.
• Experience with Microsoft Office.
• Strong organizational skills.
• Strong attention to detail.
• Ability to manage multiple applications and deadlines effectively.
• Strong verbal and written communication skills.
• Must have a High School Diploma.
• LMH is accredited by DNV and TJC, and as such, may require specific annual education related to specialty certifications and standards.

Licking Memorial Health Systems is an equal opportunity employer and maintains compliance with all state, federal, and local regulations. Licking Memorial Health Systems does not discriminate against applicants because of race, religion, color, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non-merit based factors protected by law.