Hybrid Job Opening - CVS Health - Coordinator II-Cumberland RI

Here are the job details for your review:

Job Title: Coordinator II
Duration: 10+ Months Contract (Potential for extension)
Location: 200 Highland Corporate Drive Cumberland RI 02864

Pay Rate:$17.90/ HR on W2

Shift Hours: Mon - Fri 7:30am - 4:00pm

It will be in office 4 days a week, and once trained there is an option to work from home on Fridays

PRESCREEN THAT NEEDS TO BE AT TOP OF EACH RESUME:
Location at tope of resume
Medicare experience? If yes, how many years of exp and a brief summary of exp
Medicaid experience? If yes, how many years of exp and a brief summary of exp
Brief summary of candidates excel experience

Description

The Payer Enrollment Coordinator will be responsible for ensuring corporate compliance with statutory requirements for Medicare, Medicaid, and Commercial enrollment for Clinics and Providers. This Individual will have the ability to work well with others; collaboratively with internal and external vendors and create partnerships through effective relationship building skills. This role will interact and work directly with new and existing Government /Commercial payers across the country. Analysis will include developing of provider and clinic level reporting insuring we are meeting all criteria for enrollment within our compliance policy for Government /Commercial. Payer Enrollment Coordinator will interface and work directly with the Providers, and also with Payer Relations and Revenue Cycle Operations Teams (Credentialing, Accounts Receivable, Billing, and Call Center) Clinical Ops Teams, and MinuteClinic Field and Operations Management, in order to ensure integration of all processes.

Position Summary

This position is responsible, under the supervision of the Manager of the Payer Enrollment Dept. to:
• Ensuring timely and accurate processing of Payer Enrollment applications (Initial and Revalidations) for Clinics and Providers.
• Provide quality control for timely and accurate individual enrollment applications submitted for Medicare and Medicaid programs.
• Resolve claims issues for individual payers in corporate billing system.
• Researching, completing and maintaining compliance with individual Government payers through credentialing, re-credentialing and audit processes and procedures.
• Contact Providers when Revalidation notices are received in order to obtain signature pages and validate current general information. Interact with the field (SPM and CPM’s) in regards to escalation notices.
• The Payer Enrollment Coordinator will be responsible for identifying and quantifying trends/issues and then effectively communicating them to the appropriate members of the management team along with what the potential impact could be.
• Minimize denials and deactivation of government applications where applicable to reduce key metrics including DSO, cost to collect, percent of aged claims, and Bad Debt.
• Update Credentialing and Billing systems with Provider information upon inquiry or receipt from Government /Commercial payers.

Experience
2-5 years work experience with Government payers
Adept at problem solving and decision making skills
Ability to work independently
Proficient in Excel
Proficient in Outlook
Willingness to learn

Education

Verifiable High School diploma or GED required; Bachelors Degree in Marketing preferred