Provider Enrollment Lead in Saratoga Springs, New York at Saratoga Hospital

🌟 Provider Enrollment Lead

📍 Location: Saratoga Springs, NY

🕒 Employment Type: Full-time

📌 Shift/Schedule: Day Shift
💼 Department: SHMG-Operations
💰 Salary Range: $23.76-$39.01/hr, based on experience and qualifications

💡 About Saratoga Hospital

At Saratoga Hospital, we’ve built a reputation for high-quality, compassionate care and a commitment to the health and well-being of our community. As part of the Albany Med Health System, we combine advanced technology with a deeply personal approach—creating a supportive environment for patients, staff, and providers alike. We believe that exceptional care starts with exceptional people.

🎯 About the Role

We’re looking for a dedicated Provider Enrollment Lead to join our team and help us continue delivering the level of care our patients and families deserve. In this role, the Provider Enrollment Lead is responsible for maintaining active status for all Saratoga Hospital and Saratoga Hospital Medical Group billing providers by coordinating initial and subsequent provider contracting and enrollment packages as required by commercial and governmental payers.

In addition, the Provider Enrollment Lead provides operational oversight of the provider enrollment team, including assigning work, training staff, monitoring enrollment workflows, and serving as the primary resource for complex enrollment issues. The Lead supports standardization of processes and acts as a liaison between Provider Enrollment, Med Staff Credentialing, Revenue Cycle leadership, and payers contracted with the Albany Med Health System.

🔍 What You’ll Do

• Complete enrollment and re-enrollment applications, including subsequent amendments, with all non-delegated and/or individual contracts for all billing providers under the Saratoga Hospital and affiliate Tax Identification Numbers
• Review and reference credentialing database for individual provider files to include up-to-date information needed to complete the required governmental and commercial payer enrollment applications.
• Provide notification to Albany Med credentialing staff of database discrepancies as needed.
• Distribute billing notifications for new or termed providers, including provider demographics, and location updates to key stakeholders.
• Develop Standard Operating Procedures (SOPs) in coordination with Saratoga Hospital Med Staff Credentialing and Albany Med Health System Credentialing departments to ensure compliant and standardized processes.
• Maintain an internal tracking system to ensure all information is accurate and logins are available.
• Update and maintain CAQH accounts and assist providers to ensure NPIs are created accurately
• Provide coordination with governmental payor applications between Saratoga Hospital Patient Financial Services and Albany Med credentialing.
• Participate in monthly collaborative meetings with insurance companies (payers) to identify and resolve errors during provider enrollment.
• Support coordination with the Albany Med Health System to implement a system-wide payor credentialing process including the use of new software for a standardized tracking system.
• Provide one-to-one assistance with providers as needed to facilitate a timely application process to commercial and governmental payors.
• Respond to and resolve questions regarding payer enrollment issues, on an individual or global basis, from physicians, non-physician providers, and administrative staff. Ability to identify resources to assist in answering questions or resolving concerns.
• Collaborate closely with the Director of Business Operations, Saratoga Hospital Med Staff, and Albany Med Health System billing and credentialing departments to examine insurance eligibility and out-of-network denials to identify root cause issues and develop strategies for resolution and prevention through education and/or process changes as appropriate.
• Provide onboarding and training for new Provider Enrollment Coordinators.
• Provide day-to-day guidance and operational oversight for Provider Enrollment Coordinators and assign and prioritize enrollment workloads to ensure timely completion of applications, revalidations, and payer updates.
• Serve as the primary resource for staff questions related to payer enrollment processes, applications, and regulatory requirements.
• Monitor teamwork queues and internal tracking systems to ensure provider enrollment timelines are met.
• Conduct regular team meetings to review enrollment status, discuss challenges, and identify workflow improvements.
• Identify opportunities for workflow improvements and assist in implementation of new systems or processes and review complex or escalated enrollment issues and coordinate resolution with internal departments or payers.
• Remain knowledgeable of all insurance products, policies and procedures, and State and Federal mandates and legislation.
• Always maintain confidentiality.
• Maintain compliance with regulatory and accrediting bodies.
• Other duties as assigned.
• Knowledge of payor enrollment of providers and its direct impact on the practice’s revenue cycle
• Excellent computer skills including Excel, Word, database systems, and internet use
• Detail oriented with above average organizational skills
• Plans and prioritizes to meet deadlines
• Excellent customer service skills; communicates clearly and effectively
• Excellent computer skills including Excel, Word, database systems, and internet use
• Detail oriented with above average organizational skills
• Plans and prioritizes to meet deadlines
• Excellent customer service skills; communicates clearly and effectively

📋 What You Bring

• Associate degree and two years of relevant payor enrollment experience, or High School Diploma with four years of relevant payor enrollment experience. Bachelor’s degree preferred.
• Five years’ experience with provider professional fee insurance coding and billing and/or credentialing
• Coding certification (Certified Professional Coder, CPC, Certified Coding Specialist, CCS, Certified Coding Specialist-Physician CCS-P) required, or Registered Health Information Technologist (RHIT) preferred.
• Certified Provider Credentialing Specialist (CPCS) or Medical Services Management Certification preferred or within two years of hire date

🙌 Why Saratoga Hospital

• A caring, community-focused culture rooted in teamwork and trust
• Supportive leadership that invests in your development and well-being
• Comprehensive benefits, including medical, dental, retirement plans, tuition assistance, and wellness programs. Click here to view our complete benefits guide.
• Opportunities to grow within the Albany Med Health System
• Located in beautiful Saratoga Springs, known for its vibrant community, outdoor recreation, and cultural attractions

🤝 Our Commitment

We are an equal opportunity employer and strongly encourage individuals of all backgrounds and experiences to apply. If you’re passionate about healthcare and community service—even if you don’t meet every qualification listed—we’d still love to hear from you.

📝 How to Apply

Click the ‘apply’ button to submit your resume and complete our online application. Applications are reviewed on a rolling basis—apply today and discover what makes Saratoga Hospital a special place to grow your career.