Enrollment Coordinator

Position Description

The Enrollment Coordinator role is responsible for completion of enrollment related tasks allowing providers to be in network with all market payers and improve access to community member care. It is essential that you are well versed in the internal Eleanor standards and workflows and ensure that your responsibilities and credentialing and enrollment workflows are in compliance with state, federal, and accreditation bodies’ standards and reflection of EH core values. This role will collaborate and directly report to the Credentialing & Enrollment Manager and provide assistance to colleagues, departments, and clinics as needed.

It is important that this role is held by an individual who is eager to grow, learn new skills, and become a subject matter expert in healthcare enrollment standards. We are looking for someone who is enthusiastic about organizing and managing the transfer and completion of tasks. 

This role will involve conducting regular qualitative and quantitative reviews of both internal and external workflows and ensuring adherence to our internal policies and procedures. 

Candidate Responsibilities

• Review and update delegated credentialing rosters on a monthly basis 
• Complete enrollment applications and coordinate with internal providers to gather required documentation 
• Update provider information in systems and notify relevant parties of changes.
• Stay informed about payer requirements, policies, and regulations.
• Follow up with payers and providers to resolve issues and ensure timely processing of applications.
• Track provider status:, including enrollments, re-enrollments,
• Complete outreach to external bodies and push forward application review 
• Ensure CAQH remains updated with accurate information for each of our active providers 
• Support Athena provider set up and maintenance & credentialing and enrollment tasks
• Support other responsibilities and functions of the Credentialing & Enrollment department as needed 

Valued Characteristics and skills include: 

• Detail oriented 
• Organized
• Strong advocate- can communicate needs and expectations to third parties with compassion and clarity 
• Self-starter and motivated 
• Research
• Accountable- understanding gaps in your own understanding, researching information or 
• Experience with insurance structure
• Experience with G Suite and Monday.com is preferred 

Ideal to have:

• Experience in insurance verification 
• Experience communicating with payers and troubleshooting barriers to enrollment, reimbursement, etc. 
• Experience with a third party vendor completing elements of credentialing and enrollment (ideally: Verifiable/Salesforce knowledge) 
• Knowledge of PECOS and Medicare enrollment 
• Experience applying and navigating CAQH, NPDB, and NCQA standards 
• NPPES NPI Registry knowledge
• Experience working within the Billing functions of the EHR Athena

You’ll be a good fit if you:

• Are detail oriented and efficient
• Have experience serving on interdisciplinary teams and enjoy working in a collaborative environment
• Enjoy finding opportunities to improve, developing solutions, and communicating those opportunities to peers & leaders in an actionable and collaborative way
• Enjoy meeting new people and establishing mutually beneficial working relationships
• Have experience working in a startup environment, flexible, adaptable 

Compensation & Benefits:

This is a full-time position at 40 hours per week. The target compensation range for this position is $22-24/hour. The actual compensation offered depends on a variety of factors, which may include, as applicable, the applicant’s qualifications for the position; years of relevant experience; specific and unique skills; level of education attained; certifications or other professional licenses held; other legitimate, non-discriminatory business factors specific to the position; and the geographic location in which the applicant lives and/or from which they will perform the job.

About Eleanor Health

Eleanor Health is the first outpatient addiction and mental health provider delivering convenient and comprehensive care through a value-based payment structure. Committed to health and wellbeing without judgment, Eleanor Health is focused on delivering whole-person, comprehensive care to transform the quality, delivery, and accessibility of care for people affected by addiction.

To date, Eleanor Health operates multiple clinics and a fully virtual model statewide across Louisiana, Massachusetts, New Jersey, North Carolina, Ohio, Texas, Florida, and Washington, delivering care through population and value-based partnerships with Medicare, Medicaid, and employers.

If you are passionate about providing high quality, evidence based care for individuals with substance use disorder through an innovative practice and about building a great business that makes a difference, Eleanor Health is an ideal opportunity for you. We seek highly skilled, motivated and compassionate individuals who take responsibility and adapt quickly to change to join our deeply committed and collaborative team.

Job Types: Full-Time