Provider Enrollment Coordinator

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A Brief Overview

Join Our Team at CHOPPA!

Provider Enrollment Coordinator - Help Power the Care Behind the Care

The Provider Enrollment team at the Children's Hospital of Philadelphia Practice Association (CHOPPA) is excited to welcome a Provider Enrollment Coordinator to our collaborative and mission-driven team.

In this important role, you'll ensure our healthcare providers are properly enrolled and credentialed by gathering and verifying essential documentation, maintaining up-to-date records, and supporting compliance throughout the enrollment and re-credentialing process. Your attention to detail and commitment to accuracy will help ensure our providers can focus on delivering the exceptional care CHOP is known for.

Work Schedule & Location:

Hybrid Schedule: Work from home four days a week, with one required in-office day every Monday.

Hours: Choose from three consistent weekday shifts:

* 7:00 AM - 3:30 PM
* 7:30 AM - 4:00 PM
* 8:00 AM - 4:30 PM

New Hires: Please note that during the initial 90 day introductory period, department policy requires two in-office days per week to support training and team integration.

If you're organized, dependable, and passionate about supporting the people who care for children, we'd love for you to apply and grow with us at CHOPPA.

What you will do

Provider Enrollment & Credentialing

• Review and prepare new hire enrollment packets to ensure accuracy, completeness, and timely submission to payers.

• Perform follow-up with physicians to collect required documentation for enrollment and re-credentialing processes.

• Send renewal reminders 30 days prior to credential expiration dates.

• Maintain accurate and current provider information to support timely reimbursement for services.

• Ensure CAQH re-attestation is completed every 120 days for all providers.

Documentation & File Maintenance

• Maintain organized provider files, including scanning and storing credentials.

• Monitor credential expiration dates and notify administrators and the Enrollment Manager of upcoming deadlines.

• Ensure accurate data entry in the NPPES system and internal physician databases.

Payer Communication & Follow-Up

• Initiate calls, letters, and other correspondence to follow up with payers.

• Track and ensure timely receipt of provider participation effective dates and provider numbers (goal: within 60 days of payer receipt of application).

• Document all communication with payers, including emails and written correspondence, for accurate record-keeping and future reference.

Support for Claims Resolution

• Collaborate with the Billing Department by providing research and documentation to assist in resolving claims issues related to provider enrollment.

Education Qualifications

• High School Diploma / GED - Required
• Associate's Degree - Preferred

Experience Qualifications

• At least two (2) years Previous experience with insurance verification, billing and/or provider relations - Required or
• At least two (2) years medical insurance verification/provider relations - Required

Required Skills and Abilities

• Working knowledge of insurance billing/provider operations within a large healthcare organization.
• Knowledge of Medicare and Medicaid policies and procedures.
• Basic proficiency with MS Word, Power Point, Excel computer programs
• Knowledge of the ECHO, NAVINET and CAQH systems
• Solid critical thinking / problem-solving skills
• Solid analytical and organizational skills.
• Ability to collaborate with stakeholders at all levels

To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must receive an annual influenza vaccine. Learn more.

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SALARY RANGE:

Salary ranges are shown for full-time jobs. If you're working part-time, your pay will be adjusted accordingly.

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At CHOP, we are committed to fair and transparent pay practices. Factors such as skills and experience could result in an offer above the salary range noted in this job posting. Click here for more information regarding CHOP's Compensation and Benefits.