Provider Enrollment Specialist

Posted 8 Days Ago
Be an Early Applicant
Country States, Pájaros Barrio, Bayamón, PRI
In-Office
Mid level
Healthtech
The Role
Manage and execute provider enrollment and re-enrollment with government and commercial payers, verify credentials and licensing, maintain enrollment databases, resolve payer issues, support onboarding, and pursue process improvements to ensure compliance and timely provider participation.
Summary Generated by Built In

About Our Company:
At Infinx, we're a fast-growing company focused on delivering innovative technology solutions to meet our clients' needs. We partner with healthcare providers to leverage automation and intelligence, overcoming revenue cycle challenges and improving reimbursements for patient care. Our clients include physician groups, hospitals, pharmacies, and dental groups.
We're looking for experienced associates and partners with expertise in areas that align with our clients' needs. We value individuals who are passionate about helping others, solving challenges, and improving patient care while maximizing revenue. Diversity and inclusivity are central to our values, fostering a workplace where everyone feels valued and heard.

A 2025 Great Place to Work®

In 2025, Infinx was certified as a Great Place to Work® in both the U.S. and India, underscoring our commitment to fostering a high-trust, high-performance workplace culture. This marks the fourth consecutive year that Infinx India has achieved certification and the first time the company has earned recognition in the U.S.

Location: Fully remote role with expected work hours from 8:30 AM to 5PM CT Mon-Fri. 

Summary Description: 

The Provider Enrollment Specialist will be responsible for coordinating the requests for participation in health insurance network as a medical provider, monitoring, and maintaining the provider enrollment and re-enrollment process in a timely and compliance manner with all government and commercial payors. They will also review provider credentialing and/or recredentialing data for accuracy based on licensing requirements and various insurer payer requirements. 

Job Responsibilities: 

  • Completes provider payer enrollment with all identified payers in a timely manner. 
  • Resolves enrollment issues through collaboration with physicians, non-physicians, office staff, management, contracting, insurers, and others as identified. Maintains positive working relationships with providers.
  • Plays an active role in explaining providers and practice/office managers of the submission requirements for credentialing/recredentialing processes, stressing the importance of compliance with these processes. 
  • Obtains updated provider information from various sources including provider offices, state licensing boards, malpractice insurance companies, residency training programs, etc.
  • Identifies and resolves problems with primary source verification elements by interpreting, analyzing, and researching data. 
  • Proactively obtains updated provider credentialing data prior to expiration. Creates, develops, and maintains applicable matrices and/or utilizes departmental software that supports the enrollment functions. Completes all additions, updates, and deletions. Supports new provider onboarding processes as related to enrollment. 
  • Communicates updated payer enrollment information including payer provider numbers to practice operations in a timely manner while fostering working relationships and teamwork with departments, vendors, etc. 
  • Develops databases and spreadsheets for tracking organization providers. Ensures data is accessible/transparent for executive inquiries or other information as deemed necessary by management. 
  • Continuously searches for process improvements to achieve accuracy and efficiencies. 
  • Performs other duties as assigned or required.

Skills and Education: 

  • High School Diploma or equivalent
  • 3 years of experience with payer enrollment requirements
  • Experience with California provider enrollment processes
  • Experience with California Medicaid
  • Minimum of 3 years of optometry and/or ophthalmology experience 
  • Experience with Medicare enrollment experience for Ophthalmologist and Optometrist
  • Experience with Modio
  • Experience with provider enrollment auditing and quality assurance preferred
  • Proficiency in Microsoft Word, Excel, Outlook, PDF Software and other management tools
  • Motivated to quickly learn and demonstrate strong problem-solving skills
  • Strong project management and multitasking skills
  • Excellent interpersonal and communication skills
  • Strong writing skills and attention to detail
  • Strong organizational skills and ability to be attentive to details
  • Demonstrated knowledge of healthcare contracts preferred

Company Benefits and Perks:

Joining Infinx comes with an array of benefits, flexible work hours when possible, and a genuine sense of belonging to a dynamic and growing organization.

  • Access to a 401(k) Retirement Savings Plan.
  • Comprehensive Medical, Dental, and Vision Coverage.
  • Paid Time Off.
  • Paid Holidays.
  • Additional benefits, including Pet Care Coverage, Employee Assistance Program (EAP), and discounted services.

If you are a dedicated and experienced Provider Enrollment Specialist ready to contribute to our mission and be part of our diverse and inclusive community, we invite you to apply and join our team at Infinx.

Skills Required

  • High School Diploma or equivalent
  • 3 years of experience with payer enrollment requirements
  • Experience with California provider enrollment processes
  • Experience with California Medicaid
  • Minimum of 3 years of optometry and/or ophthalmology experience
  • Experience with Medicare enrollment for Ophthalmologist and Optometrist
  • Experience with Modio
  • Proficiency in Microsoft Word, Excel, Outlook, PDF software and other management tools
  • Motivated to quickly learn and demonstrate strong problem-solving skills
  • Strong project management and multitasking skills
  • Excellent interpersonal and communication skills
  • Strong writing skills and attention to detail
  • Strong organizational skills and attention to detail
  • Experience with provider enrollment auditing and quality assurance
  • Demonstrated knowledge of healthcare contracts

Infinx Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Infinx and has not been reviewed or approved by Infinx.

  • Fair & Transparent Compensation Pay is considered competitive in several markets, and U.S. postings show clear hourly ranges for entry- to mid-level revenue-cycle roles. Salary is characterized as on time and dependable.
  • Healthcare Strength U.S. offerings include medical, dental, and vision, with some instances of employer-paid medical coverage and HSA support. Coverage is described as strong in certain cases.
  • Retirement Support A 401(k) with employer matching is included in U.S. materials and some role listings. This indicates structured retirement support alongside core health coverage.

Infinx Insights

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The Company
HQ: San Jose, CA
1,542 Employees
Year Founded: 2012

What We Do

Infinx Healthcare provides innovative and scalable prior authorization and revenue cycle management solutions for healthcare providers, hospitals, imaging centers, and laboratories. Combining intelligent, cloud-based software driven by artificial intelligence and automation, with exception handling by our certified prior authorization and billing specialists, Infinx helps clients preserve and capture more revenue, enabling them to shift focus from burdensome administrative details to billable patient care.

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