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    Pediatrix & Obstetrix Careers

    Provider Enrollment Specialist

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    Requisition ID:
    51655
    Location:
    Remote
    Type:
    Full Time
    Remote Job | Work From Home!

    Job Details

    We have a Provider Enrollment Specialist career opportunity for an experienced professional to join our team at Pediatrix Medical Group. We are a national organization, and one of the nation’s largest providers of prenatal, neonatal and pediatric services.

    Talented business professionals from diverse backgrounds choose Pediatrix because we are an exciting and innovative company that focuses on a team approach to improve the lives of patients everywhere. We are confident that you'll love being a part of the Pediatrix team. 

    Requirements

    The Provider Enrollment Specialist is responsible for timely and effectively enrolling practitioners in health plans. The Provider Enrollment Specialist will monitor progress, ensure timeliness of enrollment completion, and provide updates as needed. The Provider Enrollment Specialist II will assist Management in maintaining provider enrollment goals for all divisions. 

    • Validate and submit enrollment forms; follow up until completion.
    • Verify and update provider data in IntelliCred, Master Database, and CAQH.
    • Map forms, prioritize tasks, and research health plan requirements.
    • Document assignments in tracking systems. 
    • Contact health plans to confirm requirements and maintain current forms.
    • Prepare/review group applications for acquisitions, mergers, and growth initiatives.
    • Collaborate with Business Development, Integration, and Credentialing for required documents.
    • Maintain accurate provider profiles in IntelliCred and CAQH, including demographics, locations, and expirables.
    • Monitor delegated health plan enrollment reports for timely processing.
    • Validate onboarding enrollment status to meet target start dates; escalate as needed.

    Qualifications

    Education/Experience:

    • Associate's degree (A. A.) or equivalent from two-year college or technical school.
    • Three (3) or more years related experience or equivalent combination of education and experience.

    Knowledge/Skills:

    • Knowledgeable with Group Entity health plan enrollments, state regulations and appeal processes.
    • Knowledgeable in Provider Enrollment policies and procedures and ensuring they are being followed and keeping the loss of revenue from delayed enrollments at a minimum
    • Ability to read, analyze, and interpret common and technical journals, financial reports, and legal documents. 
    • Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community.  Ability to write speeches and articles for publication that conforms to prescribed style and format.
    • Ability to effectively present information to top management, public groups, and/or boards of directors.
    • Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry. 
    • Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
    • Ability to define problems, collect data, establish facts, and draw valid conclusions.
    • Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
    • Ability to understand medical terminology and protocols

    Software:

    • Experience in Excel, Word, Adobe Professional, Pediatrix Master Database, OnBase, WorkView, hCue (Entity database software)
    • CAQH, and Credentialing/Provider Enrollment Tracking Software (IntelliCred).

    Benefits and Compensation

    Take great care of the patient, every day and every way.TM At Pediatrix & Obstetrix, that’s not only our motto at work each day; it’s also how we view our employees and their families. We know that our greatest asset is YOU.  

     

    We take pride in offering comprehensive benefits in a vast array of plans that fit your life and lifestyle, supporting your health and overall well-being. Benefits offered include, but are not limited to: Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA and HSAs, as well as a 401k plan and Employee Stock Purchase Program. Some benefits are provided at no cost, while others require a cost share between employees and the company. Employees may also select voluntary plans and pay for these benefits through convenient payroll deductions. Our benefit programs are just one of the many ways Pediatrix & Obstetrix helps our employees take care of themselves and their families.  

    Pediatrix is an Equal Opportunity Employer

    All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

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    Please Note: Fraudulent job postings/job scams are becoming increasingly common. All genuine Pediatrix job postings can be found through the Pediatrix Careers site.

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