Provider Enrollment Coordinator

Start the day excited to make a difference...end the day knowing you did. Come join our team.

Essential Functions & Responsibilities:

• Prepare, submit, and track provider enrollment applications to Medicare, Medicaid, and commercial payers.

• Manage and maintain enrollments, including revalidations, recredentialing, terminations, and demographic updates.

• Maintain and update CAQH profiles, ensuring timely attestation and documentation accuracy.

• Collect, verify, and organize provider documents including licenses, board certifications, DEA, CDS, CVs, and malpractice insurance.

• Process Medicare PECOS enrollments, reassignments and provider changes.

• Ensure compliance with federal, state, and payer-specific enrollment and credentialing requirements.

• Serve as a liaison between providers and payer representatives to streamline enrollment processes.

• Coordinate with Recruiting, HR, Medical Support Services, and onboarding teams to ensure timely credentialing for new hires.

• Coordinate with billing and reimbursement teams to resolve enrollmentrelated claim edits, billing holds, and payment delays. Research and resolve discrepancies while maintaining accurate documentation and records to support audits and compliance reviews.

• Perform other duties as assigned.

Qualifications:

• High school diploma required; Associate's or Bachelor's degree preferred.

• A minimum of 1 year of experience required. Two or more years preferred.

• Prior experience with Medicare/Medicaid processes and CAQH preferred.

• Familiarity with credentialing software systems strongly preferred.

• Strong attention to detail and accuracy in data entry and documentation.

• Excellent organizational skills with the ability to manage multiple tasks and deadlines.

• Effective written and verbal communication skills.

• Proficiency with Microsoft Office applications and credentialing databases.

• Ability to work both independently and within a team environment.

As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.

Physical Requirements: Constant (67-100% of workday) sitting and use of arms and hands; occasional (0-33% of workday) standing, walking, bending, squatting; ability to lift, push, and pull up to 10 lbs.; auditory and visual skills.

Mental Requirements: Possesses critical thinking and analytical skills. Ability to multi-task. Ability to communicate effectively and collaborate with a multi-disciplinary team.

Environmental Requirements and Exposure Hazards: Potential risk of exposure to chemicals.

"It is the policy of Mary Washington Healthcare to provide reasonable accommodations to qualified individuals with a disability who are applicants for employment or Associates."