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Payor Enrollment Coordinator- PAA Requisition ID 2024-48624 Category Professional Overview This position serves as a primary contact within the Payor Enrollment team at Nationwide Children's Hospital's for multispecialty medical groups regarding provider enrollment with various health plans. Collaborates with physicians, nurse practitioners, operational managers, department administrative support staff, and health plans to ensure providers are actively enrolled with contracted health insurance companies. Collaborates with the Medical Staff Office to ensure providers are properly enrolled with contracted payors once they begin employment. Also collaborates with PFK (Partners for Kids) and Payor Relations staff to ensure a stream-lined approach across continuum of payors. Works with highly confidential information under minimal supervision. Why Nationwide Children's Hospital? The moment you walk through our doors, you feel it. When you meet our patient families, you believe it. And when you talk with anyone who works here, you want to be part of it. Welcome to Nationwide Children's Hospital, Where Passion Meets Purpose. Here, Diversity, Equity and Inclusion are integrated into our core values and practices. We are passionate about building, sustaining and evolving an inclusive and equitable environment. We are seeking individuals who live these values and want to share their experiences and efforts in support of our collective mission. We're 14,000 strong. And it takes every one of us to improve the lives of the kids we care for, and the kids around the world we'll never meet. Kids who live healthier, fuller lives because of the knowledge we share. We know it takes a Collaborative Culture to deliver on our promise to provide the very best, innovative care and to foster new discoveries, made possible by the most groundbreaking research. Anywhere. Ask anyone with a Nationwide Children's badge what they do for a living. They'll tell you it's More Than a Job. It's a calling. It's a chance to use and grow your talent to make an impact that truly matters. Because here, we exist simply to help children everywhere. Nationwide Children's Hospital. A Place to Be Proud. Responsibilities Payor Enrollment Coordinates the payor enrollment function for physicians and nurse practitioners for payors not delegated. Prepares payor enrollment packets for new physicians, nurse practitioners, certified registered nurse anesthetists, genetic counselors, pathologists, dentists, and physician assistants prior to their employment. Sends packets to health plans and does appropriate follow-up. Notifies health plans of termination of provider participation as needed. Maximizes use of online applications to expedite processing time. Educates providers regarding the processes of registering with the Federal Credential Verifications Services, obtaining Ohio medical license/DEA, and obtaining Medical Staff privileges. Validates Council for Affordable and Quality Healthcare (CAQH) profile for each physician every 90-120 days and uploads certifications quarterly. Annually uploads liability information on all providers. Maintains a file of all relevant payor enrollment-related information for each physician, including current Curriculum Vitaes and skill-set certifications (ex: PALS). Responsible for updating all assigned providers in SharePoint to provide all parties with status update for enrollment process. Serves as a liaison with Division/Section Chiefs, Service Line Administrators, and PAA Administration to provide status updates. Tracks the following items: status level of privileges at NCH and other hospitals, malpractice coverage history for each physician, status of enrollment with various payors. Provides updates to the Profes