Analyst, Provider Enrollment

MDVIP LLC•Boca Raton, FL

6h•Remote

About The Position

MDVIP is seeking a Provider Enrollment Analyst to manage the insurance provider enrollment process for its MDVIP physician affiliates. This role requires a deep understanding of credentialing & contracting procedures and the ability to provide accurate guidance and support to affiliated physicians, physician staff, and internal teams. The Analyst will coordinate with and support the Insurance Services Department in resolving complex issues. They will serve as a liaison between MDVIP and insurance carriers, commercial and federal clearinghouses, and regulatory bodies. Additionally, the role ensures compliance with all licensing and credentialing requirements for MDVIP affiliated physicians.

Requirements

Associate’s degree and at least two (2) years related business experience.
Four (4) years of related work experience.
Familiarity with EMR and credentialing software.
Proficient in Microsoft Office applications.
Successful track record in a similar corporate role focused on coordination or management of provider enrollment.
Interprets complex data using experience and critical thinking to support insights.
Builds collaborative, productive relationships with physicians, physician staff, and stakeholders.
Communicates clearly, professionally, and effectively across diverse audiences.
Proactively identifies solutions, pursues growth, and seeks added responsibility.
Demonstrates accountability, meets deadlines, and maintains daily preparedness.
Applies strategic thinking to assess risks, trends, and opportunities for informed decision-making.

Nice To Haves

Experience with CAQH, PECOS & NPPES applications.
Experience with Net Docs, credentialing software, and athena.
Certified Provider Credentialing Specialist (CPCS).
Certified Provider Enrollment Specialist (CPES).
Experience with Salesforce or other CRM tools.

Responsibilities

Manages non-standard provider enrollment workflows, interpreting payer-specific contract requirements and independently navigating complex scenarios.
Accountable for end-to-end provider enrollment and contracting coordination through completion, delivering responsive, high-quality service while proactively educating physicians on timelines, managing expectations, and maintaining strong partnerships.
Serves as the primary liaison and subject-matter expert for provider enrollment, collaborating across physicians, internal stakeholders, and external partners.
Completes statewide credentialing applications to establish new groups and add providers to commercial payers and Medicare.
Serves as the authoritative steward of provider enrollment data, conducting detailed analysis and reconciliation across multiple systems to identify discrepancies and potential impacts.
Maintains provider enrollment system processes, policy, and procedures, ensuring adherence to all requirements and taking corrective steps as needed.
Exercises independent judgment to resolve enrollment obstacles and exceptions, escalating only high-risk, systemic, or time-sensitive issues with defined solution options and impact assessments.
Maintains operational and regulatory integrity of provider enrollment data by independently managing, validating, and reconciling complex provider records across high-volume, payer-specific enrollment workflows.
Provides training and guidance to affiliates, physician staff, or respective billing companies related to MDVIP preventive billing protocols and/or provider enrollment needs.
Develops, analyzes, and distributes timely status reports to affiliated physicians and field staff, proactively managing follow-ups.
Compiles, validates, and delivers comprehensive insurance-related reports and management presentations, translating complex data into clear insights.
Conducts detailed analysis and reconciliation of provider enrollment data to support accurate contracting, payer submissions, and ongoing network compliance.
Independently identifies, evaluates, and synthesizes complex enrollment and contracting issues, delivering clear root-cause analysis and actionable recommendations to management.
Resolves escalated issues and urgent requests.

Benefits

Competitive compensation: attractive base salary complemented by performance-based incentives for eligible roles.
Comprehensive benefits: health, dental, vision insurance, and retirement plans.
Professional development: access to ongoing training and leadership development programs.
Medical/prescription drug coverage
Dental coverage
Vision coverage
Flexible Spending Account
Health Savings Account
Dependent Care Flexible Spending Account
Basic and Supplemental Life Insurance & Accidental Death and Dismemberment
Disability Income Protection Plan
Employee Assistance Program
401(k) retirement program
Vacation, Paid Holidays and Personal time
Paid Sick and Family and Medical Leave time as required by law.