Medical Provider Enrollment and Onboarding Specialist (Fort Lauderdale)

$39,520 - $52,000/Yr

Codemax Medical Billing - Fort Lauderdale, FL

Full-time

Fort Lauderdale, FL

Administrative and Support Services

About the position

The Provider Enrollment and Onboarding Specialist is responsible for managing the enrollment and onboarding process for healthcare providers within the organization. This role ensures that providers are properly qualified and enrolled with insurance networks, maintaining compliance with industry standards and regulations.

Responsibilities

• Manage all aspects of the provider enrollment and onboarding process, including initial applications, re-credentialing, and maintaining provider information in all necessary systems.
• Perform primary source verification of provider credentials, including education, training, licensure, and certifications.
• Coordinate with insurance payers to complete provider enrollment applications.
• Manage delegated credentialing agreements, ensuring that internal processes meet insurance company standards.
• Work with healthcare providers to complete necessary paperwork and answer questions about the enrollment and credentialing process.
• Stay up to date with changes in regulations and standards from organizations such as NCQA, TJC, and CMS.
• Maintain accurate records and ensure that all credentialing documents are current and comply with industry standards.
• Handle provider privilege process, collaborating with the medical staff office when needed.
• Work collaboratively with other departments to resolve credentialing and enrollment issues.
• Perform all other duties as assigned.

Requirements

• Proficiency in Microsoft Office Suite, specifically Excel and Word.
• Excellent attention to detail and organizational skills.
• Strong written and verbal communication skills.
• Ability to handle sensitive information confidentially.
• A minimum of 2 years of experience in provider enrollment and credentialing.
• In-depth understanding of healthcare regulations, accreditation standards, and credentialing requirements.

Nice-to-haves

• Experience in a managed care setting is preferred.

Benefits

• Health Insurance
• Vision Insurance
• Dental Insurance
• 401(k) plan with matching contributions