Provider Enrollment Specialist

Pediatrix Medical Group; Sunrise (FL); Remote; USD 45,000 - 65,000; Full time

Job summary

Pediatrix Medical Group is seeking a Provider Enrollment Specialist II to manage the enrollment of practitioners in health plans. This full-time remote position requires an Associate's degree and three years of relevant experience. The role involves validating enrollment forms, monitoring progress, and ensuring compliance with health plan requirements. Benefits include medical, dental, vision, and retirement plans.

Benefits

Medical benefits

Dental benefits

Vision benefits

Retirement plans

Parental leave

Qualifications

• Three or more years of related experience.
• Understanding of provider enrollment policies.
• Experience with databases and credentialing software.

Responsibilities

• Enroll practitioners in health plans efficiently and timely.
• Monitor assigned health plan enrollment reports.
• Validate onboarding status and ensure target dates are met.

Skills

Knowledge of health plan enrollments

Ability to interpret technical documents

Proficiency in mathematical concepts

Education

Associate's degree or equivalent

Tools

Excel

Word

Adobe

credentialing software

Job description

Requisition ID:

2025-49250

Location:

US--US: Remote

Position Type:

Full Time

HR Rep / Recruiter:

Marcia Harrison

Responsibilities

The Provider Enrollment Specialist II is responsible for enrolling practitioners in health plans efficiently and timely. They monitor progress, ensure enrollment completion, and update the relevant RCM offices. They also assist management in maintaining provider enrollment goals across divisions.

• Validate up-to-date plan enrollment forms, complete applications, submit them, and follow up until enrollment is finalized. Verify accuracy and coordinate data entry into IntelliCred and Master Database.
• Map forms in IntelliCred, prioritize work, review and research health plan requirements, and document assignments per SOPs.
• Contact health plans to determine requirements, verify forms, and ensure the latest application forms are available in Provider Enrollment Tracking Software.
• Prepare and review group applications during acquisitions, mergers, and growth initiatives.
• Coordinate with Business Development, Integration, and Credentialing to gather necessary documents and signatures.
• Maintain provider profiles in PE Tracking system and CAQH with current information.
• Monitor assigned health plan enrollment reports for timely processing and escalate issues to management.
• Validate onboarding status, ensure target dates are met, and escalate when necessary.
• Perform other related duties as assigned by management.

Qualifications

Education/Experience:

• Associate's degree or equivalent from a two-year college or technical school.
• Three or more years of related experience or equivalent education and experience.
• Knowledge of health plan enrollments, regulations, and appeal processes.
• Understanding of provider enrollment policies and procedures to minimize revenue loss.
• Ability to interpret technical and legal documents, respond to inquiries, and present information effectively.
• Proficiency in mathematical concepts, medical terminology, and protocols.
• Experience with Excel, Word, Adobe, databases, and credentialing software.

Benefits and Compensation

Includes medical, dental, vision, fertility benefits, retirement plans, stock purchase, insurance, FSA/HSA, FMLA, parental leave, and various discounts.

About Us

Pediatrix Medical Group is a leading provider of specialized healthcare for women, babies, and children, committed to quality, research, and safety since 1979.

Please note: All genuine job postings are available on our official careers site: www.pediatrix.com/careers.

#LI-Remote #PedNC

Pediatrix is an Equal Opportunity Employer. All qualified applicants will receive consideration regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.