Senior Provider Enrollment Specialist

| Orlando, FL
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Join VillageMD as a Senior Provider Enrollment Specialist in Orlando, FL

Join the frontlines of today's healthcare transformation

Why VillageMD?

At VillageMD, we're looking for a Senior Provider Enrollment Specialist to help us transform the way primary care is delivered and how patients are served. As a national leader on the forefront of healthcare, we've partnered with many of today's best primary care physicians. We're equipping them with the latest digital tools. Empowering them with proven strategies and support. Inspiring them with better practices and consistent results.

We are creating care that's more accessible. Effective. Efficient. With solutions that are value-based, physician-driven and patient-centered. To accomplish this, we're looking for individuals who share our sense of excellence, are ready to embrace change, and never settle for the status quo. Individuals who have the confidence to lead but the humility to never stop learning.

Could this be you?

Integral to our team, you will be responsible for daily management of the physician payor enrollment processes, workflows and controls associated with enrollment.  You will also be responsible for completion of provider credentialing records to ensure credentialing records comply with regulatory and accrediting agencies.  The Medical Credentialing Specialist is the liaison between the physicians, the payors and VillageMD.

How you can make a difference

  • Oversee day to day activities for payor credentialing functions.
  • Ensure protocols are being followed to ensure timely resolution and completion of payor enrollment to ensure no loss of revenue due to untimely payor enrollment.
  • Responsible for oversight of any outside vendor contracted to assist with payor enrollment.
  • Accurately prepare all required paperwork for provider payor enrollment/reenrollment.
  • Audit all paperwork before submitting ensuring the paperwork is completed and the data is correct.
  • Responsible for retaining a professional working relationship with all payors and providers.
  • Work closely with management in other areas of VillageMD and the client(s) to ensure seamless coordination and timely enrollment of new providers coming into the organization.
  • Develops timelines for completion of projects.
  • Provide weekly enrollment updates to management.
  • Responsible for communicating any potential issues with providers not completing required paperwork.
  • Ensure quantity and quality of work for meeting productivity/quality standards.
  • Assists with special projects as needed.

Skills for success

  • A willingness to learn, take initiative and be resourceful
  • A bias for action and pragmatic solutions
  • Detail oriented, ability to manage and prioritize requests, and effectively communicate
  • The ability to be flexible in an ambiguous and dynamic environment
  • Ability to solve problems, and establish trust
  • A low ego and humility; an ability to gain trust through strong communication and doing what you say you will do
  • Strong desire to learn and grow within a fast-growing company

Experience to drive change

  • High school diploma required; Associates degree preferred.
  • 3 or more years of experience in a provider/payor enrollment position is required.
  • Relevant certification such as CPCS or CPMSM is preferred. 
  • Demonstrated knowledge of third-party and insurance company operating procedures, regulations and billing requirements, and government reimbursement programs.
  • Working knowledge of payor credentialing rules and regulations.
  • Experience with CAQH.
  • Experience with Medicare and Medicaid provider enrollment applications and processes.
  • Demonstrated knowledge of how physician payor enrollment affects the revenue cycle.
  • Adds value to the organization through proactive analysis of and resolution to potential bottlenecks that may negatively affect the organization’s reimbursement and accounts receivable.
  • Demonstrated success and skill in management of projects and meeting deadlines.
  • Must possess excellent communication and diplomacy skills, demonstrate the ability to work in a team environment, and be able to effectively manage multiple work processes simultaneously.
  • Must have proven organizational skills
  • Possess the ability to effectively prioritize and present information publicly and communicate in writing clearly, concisely, thoroughly, and accurately.
  • Solid PC skills, specifically with Microsoft Word and Excel.

How you will thrive

In addition to competitive salaries, a 401k program with company match, bonus and a valuable health benefits package, VillageMD offers paid parental leave, pre-tax savings on commuter expenses, and generous paid time off. You work in a highly-collaborative, conscientious, forward-thinking environment that welcomes your experience and enables you to make a significant impact from Day 1.

Most importantly, you make a difference. You see a clear connection between your daily work on VillageMD products and services and the advancement of innovative solutions and improved quality of healthcare for providers and patients.

Our unique VillageMD culture – how inclusion and diversity make the difference

At VillageMD, we see diversity and inclusion as a source of strength in transforming healthcare. We believe building trust and innovation are best achieved through diverse perspectives. To us, acceptance and respect are rooted in an understanding that people do not experience things in the same way, including our healthcare system. Individuals seeking employment at VillageMD are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. 

Explore your future with VillageMD today.

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