Children's Wisconsin · 7 hours ago
Provider Data Enrollment Coordinator
United States
Full-time
Remote
Senior Level
5+ years expChildren's Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. They are hiring an experienced Provider Data Enrollment Coordinator to manage the enrollment for employed providers with various insurance and managed care entities, ensuring accurate data entry and completion of required information.
AssociationBiotechnologyEducationHealth CareMedical
Responsibilities
Coordinates the specific application requirements for each entity that provider will need to be enrolled
Obtains and assembles necessary information and documents for the provider enrollment
Performs audits of the provider files to ensure data integrity of required information prior to processing applications
Problem-solves with providers to obtain missing data or documents required for the various applications and enrollment forms
Enters all provider information onto the initial and on-going payer enrollment and credentialing applications in accordance with the CHHS process guidelines. This will include the hospital privileging applications and reappointments to hospital entities
Coordinates the completion of initial applications for malpractice insurance for all CHHS employed providers and manages the distribution of all certificates annually
Enters the provider data into the database tool to ensure current information is captured for the entities that require electronic submission of provider information for enrollment. Coordinates ongoing audits of the database for accuracy of all provider data entered
Develops and maintains electronic copies of all completed enrollment and credentialing provider data files in an organized and timely manner
Maintains the participation matrix by provider and facility that is used to track participation of the provider or facility in the various contracted networks and contracts
Manages ongoing expireables process for all providers and assures that updated information is obtained, stored, and provided as applicable within the expected timeframe
Continually improves and develops processes and/or systems to gain efficiencies that affect the payer enrollment and credentialing process of CHHS employed providers
Organizes credentialing and physician files for Senior Credentialing Coordinator for audits by regulatory authorities
Provides support as needed to the Payer Contracting and Revenue Cycle teams to investigate issues and resolve problems related to provider participation status, claim submission and payment
Drafts and distributes notices of additions, changes, and terminations of provider information
Verifies the ongoing accuracy of on-line and paper provider directories
Qualification
Required
Minimum of five years of Payer credentialing, managed care, health insurance, or health system experience required
Proficient with Microsoft Office, including Outlook email with an emphasis on Excel and Word required
Maintains a high degree of confidentiality in dealing with sensitive provider issues and data
Strong customer service and interpersonal skills to work well with internal (physicians, etc.) and external customers (insurance companies, etc.)
Strong organizational skills with the ability to prioritize and meet deadlines
Must be detail-oriented in order to ensure all required information/data has been received and processed to meet credentialing timelines
Must be able to work cohesively in a team oriented environment and able to foster good working relationships with others both with internal and external customers
Preferred
Associates Degree preferred
Ability to type 30+ words per minute preferred
Company
Children's Wisconsin
The Childrens Hospital Research Institute is a research institute dedicated solely to the health and well-being of children.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Gil Peri
President and Chief Executive Officer
J
Jason Jarzembowski
Chief Executive Officer
Recent News
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2026-01-19
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