Enrollment Coordinator
Columbia University - New York, NY

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Department

7560- FPO Faculty Practice Org

Location

Medical Center

Job Type

Officer Full-Time Regular

Bargaining Unit

If temporary, indicate duration

Hours Per Week

Job Family

General Administration

Salary Grade

Officer 103

Salary Range

Commensurate with experience

Advertised Summary Job Description

Responsible for reviewing, inputting and tracking high volume Provider credentialing applications to ensure timely and efficient enrollment of eligible providers in the ColumbiaDoctors network and respective contracted managed care plans. Develop and maintain relationships with Managed Care Representatives and internal staff. Review and route all membership applications and affiliated documents according to PEG policies and procedures. Respond to provider inquiries with regard to application explanation and status. Ensure the prompt data entry of initial physician records in the PEG database, production of eligibility lists for payors participation, and submission/follow-up of provider disenrollment or opt-outs from payor plans. Responsibilities include: 1. Process new provider enrollment requests from departments in a timely fashion. Review all data/documents entered for accuracy. Provide feedback to departments per PEG policy and procedures regarding missing or incomplete data/documents. 2. Submit all documents for credentialing/recredentialing to appropriate parties in a timely manner. Review all documents prior to submission to ensure completion and accuracy. 3. Update PEG database accurately to reflect all steps taken. Responsible for follow-up of applications, delegated spreadsheet submissions, updates and terms returned to physician or designee for missing information. Inform manager of delays related to enrollment/credentialing/recredentialing processing both internally and externally. 4. Update PEG database to reflect provider opt-in/opt-out selections for managed care participation per PEG policy and procedures. 5. Upon enrollment in managed care plans, update database with accurate provider identification numbers. Inform physician or designee in a timely fashion. Verify correct loading of physician demographic and tax identification information in payor system. Produce reports for review by departmental administrators and billing office personnel. 6. Submit demographic updates to managed care plans as requested in timely manner per PEG policy and procedures. Track confirmations as received, update database, and inform departments accordingly. 7. Manage the ongoing process required for physician disenrollment or opt outs from managed care plans, change of ColumbiaDoctors level of affiliation, and exclusivity waivers for ColumbiaDoctors members. Maintain an understanding of the various faculty affiliations and takes appropriate action steps. 8. Review provider participation rosters and compare information to PEG database. Follow up with payors for verification and completes reconciliations accordingly. Review and correct provider demographic information prior to printing of payor Provider Directories. 9. Establish and maintain positive relationships with physicians, administrators and Managed Care Organization representatives. 10. Log and track departmental issues as related to enrollment, credentialing, and demographics; exchange trackers with department on a regular basis. 11. Escalate departmental issues to Enrollment Manager and/or Director appropriately. Hold conference calls or face-to-face meetings with departmental contacts on an as needed basis, including Enrollment Manager if deemed appropriate. 12. Provide enrollment, credentialing, and demographic reports to departments on a routine basis; provide additional reports to departments as requested. 13. Assist with credentialing, enrollment and operational projects as needed.

Minimum Qualifications for Grade Applicant MUST meet these minimum qualifications to be considered an applicant

Requires a bachelor's degree or equivalent in education, training and experience, plus two years of related experience.

Additional Position-Specific Minimum Qualifications Applicant MUST meet these minimum qualifications to be considered an applicant

Specialized knowledge of Credentialing/Enrollment required. One to three years experience in the use of relational databases and their supporting programs in Microsoft software. Working knowledge of Microsoft Word, Excel, Access or comparable word processing and spreadsheet software. Attention to detail a must. Customer service orientation a must. Time management and multi-tasking skills required. Communication skills, organizational skills, and ability to prioritize.

Preferred Qualifications

Special Instructions

Special Indications This position works with:
There are no special indications for this position

HIPAA Compliance training required

Yes

Participation in Medical Surveillance required

No

What type of posting? Is this a waiver request?

Standard Posting

Requisition Open Date

04-23-2013

Requisition Close Date

Open Until Filled

Quick Link

jobs.columbia.edu/applicants/Central?quickFind=135676

EEO Statement

Columbia University is an Equal Opportunity/Affirmative Action employer.

Local Hiring

Columbia University is committed to the hiring of qualified local residents.

Columbia University - 17 months ago - save job - block
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Founded in 1922, Columbia University's Mailman School of Public Health pursues an agenda of research, education, and service to address the...