Provider Enrollment Analyst — Credentialing & Compliance

RiseMe; Boca Raton (FL); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Competitive compensation

Health, dental, and vision insurance

Retirement plans

Professional development

Great Place to Work culture

Job summary

MDVIP is seeking a Provider Enrollment Analyst reporting to the Manager of Insurance Programs to manage the insurance provider enrollment process for our MDVIP physician affiliates. This role requires a deep understanding of credentialing and contracting procedures and the ability to guide and support affiliated physicians and staff.

You’ll coordinate with the Insurance Services Department to resolve complex issues and serve as a liaison between MDVIP, insurance carriers, and regulatory bodies

Qualifications

• Associate’s degree and at least two years related business experience.
• Four years of related work experience.
• Familiarity with EMR and credentialing software.
• Proficient in Microsoft Office applications.

Responsibilities

• Manages non-standard provider enrollment workflows, interpreting payer-specific contract requirements and independently navigating complex scenarios.
• End-to-end provider enrollment and contracting coordination through completion with proactive physician education on timelines.
• Serve as primary liaison for provider enrollment, collaborating with internal and external stakeholders to drive alignment and service quality.
• Complete statewide credentialing applications to establish new groups and add providers to payers and Medicare.
• Maintain provider enrollment data across systems, identify discrepancies and risks to revenue and compliance.
• Maintain enrollment system processes, policies and procedures, ensuring adherence to requirements.
• Resolve enrollment obstacles, escalating high-risk issues with defined solutions.
• Manage provider enrollment data integrity across high-volume workflows.
• Provide training to affiliates on preventive billing protocols and enrollment needs.

Skills

Credentialing coordination

Data analysis

Communication

Project coordination

Education

Associate’s degree

Tools

CAQH

PECOS

NPPES

Salesforce

Athena

NetDocs

Job description

MDVIP is seeking a Provider Enrollment Analyst reporting to the Manager of Insurance Programs to manage the insurance provider enrollment process for our MDVIP physician affiliates. This role requires a deep understanding of credentialing and contracting procedures and the ability to guide and support affiliated physicians and staff.

You’ll coordinate with the Insurance Services Department to resolve complex issues and serve as a liaison between MDVIP, insurance carriers, and regulatory bodies