Enrollment Specialist

We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care.

Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians.

When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.

Please Note: We will only contact candidates regarding your applications from one of the following domains: @summithealth.com, @citymd.net, @villagemd.com, @villagemedical.com, @westmedgroup.com, @starlingphysicians.com, or @bmctotalcare.com.

The Enrollment Specialist ensures that all provider enrollment data remains current with the payers and in the Athena practice management system. The Enrollment Specialist assists in preparing and submitting enrollment applications and supporting documentation for the purpose of maintaining participating status for individual physicians, facilities, and privileges. In this role, the enrollment specialist ensures that the providers, facilities, and services are set up for electronic claims submission and remittance. The Revenue Cycle Enrollment Specialist ensures there are no disruptions in the revenue cycle due to lapses in payer enrollment and accreditation. 

How You Will Get Things Done: 

• Manage Athena enrollment tasks dashboard to ensure provider/department/facility data is accurate and complete
• Knowledgeable of payer enrollment policies and updates internal documents and checklists according to department guidelines
• Assist to complete initial credentialing applications for new facility enrollment, and supplies supporting documentation as required by commercial and government payers
• Perform assigned tasks required to maintain the timelines for enrollment schedules and ensure documentation is updated and submitted as required to avoid a disruption in participating status and revenue
• Audit provider rosters and payer directories. Provides updated provider files to the payers ensure payer files are accurate and current
• Assist to coordinate enrollment data and other accreditations with the Credentialing Department
• Knowledgeable of the delegated credentialing process
• Respond to internal and external inquiries on routine enrollment and privileging matter
• Maintain a strict level of confidentiality for all matters pertaining to provider enrollment
• Perform other duties as requested

How You Will Build Trust: 

• Work closely with managers, providers and clinical staff to obtain and verify the documentation and signatures necessary to process Medicare initial enrollments, Revalidations, and initial Medicaid non-billing enrollments
• Follow up with all payers to ensure enrollment documentation is received and updated in a timely manner
• Follow up with payers to resolve the billing issues related to enrollment and ensure claims are reprocessed for payment as payer systems are updated

How You Will Innovate: 

• Assist in researching claim denials and trends related to enrollment and billing

Experience to Drive Change: 

• Bachelor’s degree preferred
• Minimum of 1 year experience in healthcare or provider enrollment/credentialing
• Knowledge of Commercial and Government insurance carrier policies and procedures as they relate to enrollment
• Proficiency in Microsoft Office, particularly Excel and Word
• Professional written and verbal communication and interpersonal skills required
• Ability to motivate teams as well as, participate and facilitate group meeting
• Ability to effectively communicate with providers, managers, clinical staff and insurance contacts
• Ability to maintain complete confidentiality in handling sensitive enrollment issues

This is a non-exempt position. The base hourly compensation range for this role is $19.00 to $24.00.  At VillageMD, compensation is based on several factors including, but not limited to education, work experience, certifications, location, etc.  The selected candidate will be eligible for a valuable company benefits plan, including health insurance, dental insurance, life insurance, and access to a 401k plan.

Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families.  Participation in VillageMD’s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.

Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.

Our Company cares about the safety of our employees and applicants. Our Company does not use chat rooms for job searches or communications. Our Company will never request personal information via informal chat platforms or unsecure email. Our Company will never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at select Our Company locations during regular business hours only. For information on job scams, visit, https://www.consumer.ftc.gov/JobScams or file a complaint at https://www.ftccomplaintassistant.gov/.