PROVIDER ENROLLMENT COORDINATOR

The Provider Enrollment Coordinator:

• Serves as the primary operational point of contact for clinical departments, physician leaders, and internal stakeholders regarding provider enrollment coordination and network participation.
• Manages end-to-end coordination of provider enrollment readiness, ensuring all required documentation, practice details, effective dates, specialties, and panel information are complete, accurate, and aligned to submission.
• Oversees data control and quality assurance processes to ensure providers are accurately loaded into enrollment, credentialing, and related systems to support timely billing and reimbursement.
• Partners directly with payers to coordinate enrollment requirements, resolve discrepancies, clarify participation status, and proactively address issues impacting reimbursement or network access.
• Monitors enrollment timelines and prioritizes workload based on go-live dates, payer turnaround times, and operational impact, demonstrating strong time management in a deadline-driven environment.
• Communicates enrollment status, risks, and barriers to the Director of Provider Enrollment by providing clear recommendations and action plans.
• Conducts routine and targeted quality audits of provider data, payer participation, specialty alignment, and effective dates to ensure ongoing data accuracy and regulatory compliance.
• Applies critical thinking to identify trends, root causes of delays or denials, and systemic process gaps; develops and implements solutions in collaboration with leadership.
• Maintains oversight of coordination between recruitment, contracting, credentialing, revenue cycle, Medical Staff Services, onboarding, and external payers to ensure alignment and prevent downstream revenue disruption.
• Develops and refines tracking tools, reporting mechanisms, and workflow controls to strengthen visibility, accountability, and performance outcomes.
• Supports development, documentation, and communication of enrollment policies, procedures, and best practices to promote standardization and operational consistency.
• Handles confidential provider and organizational information with professionalism, discretion, and sound judgment.

Education: Associate degree required or relevant education and experience may be considered in lieu of degree.

Experience: 3 years of experience in a healthcare setting required.

Licensure, Certification, and/or Registration: None.

Other Minimum Qualifications: Strong time management skills with the ability to meet deadlines in a fast-paced environment. Excellent verbal and written communication skills. Strong attention to detail and commitment to data accuracy and integrity. Ability to work independently while collaborating effectively with cross-functional teams. Proficiency with computer applications, including word processing, spreadsheets, databases, and enrollment systems. Ability to manage multiple priorities and shift focus as business needs change. Demonstrated professionalism, discretion, and ability to handle confidential information. Customer-focused mindset with the ability to support providers and internal stakeholders effectively.

This job description is intended to be a representative summary of the major responsibilities and qualifications required for this position. Employees may be asked to perform job-related duties beyond those explicitly described.

Recruiter:

Recruiter Email:

For more information, contact the HR Service Center at 1-800-599-2537.

Carilion Clinic is an Equal Opportunity Employer: We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, national origin, age (40 or older), disability, genetic information, or veterans status. Carilion is a Drug-Free Workplace. For more information or for individuals with disabilities needing special assistance with our online application process contact Carilion HR Service Center at 800-599-2537, 8:00 a.m. to 4:30 p.m., Monday through Friday.

For more information on E-Verify: https://www.carilionclinic.org/eoe-e-verify-and-right-work-policies

Carilion understands the importance of prioritizing your well-being to help you develop and thrive. That's why we offer a well-rounded benefits package, and many perks and well-being resources to help you live a happy, healthy life - at work and when you're away.

When you make your tomorrow with us, we'll enhance your potential to realize the best in yourself.Below are benefits available to you when you join Carilion:

• Comprehensive Medical, Dental, & Vision Benefits
• Employer Funded Pension Plan, vested after five years (Voluntary 403B)
• Paid Time Off (accrued from day one)
• Onsite fitness studios and discounts to our Carilion Wellness centers
• Access to our health and wellness app, Virgin Pulse
• Discounts on childcare
• Continued education and training

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