Provider Enrollment Specialist II - Full Time - Hybrid

Experity•Machesney Park, IL

1d•$19 - $23•Hybrid

About The Position

Experity is a mission-driven team transforming on-demand healthcare across the U.S., empowering urgent care clinics with industry-leading software that makes care faster, easier, and more patient-focused. Joining us means doing meaningful work that directly improves the healthcare experience for millions—from helping families access care quickly to ensuring clinics run smoothly behind the scenes. If you want to make a real impact alongside innovative, dedicated teammates while contributing to a trusted platform that’s becoming the operating system for on-demand care, Experity is the place to grow your career.

Requirements

Associate's degree or equivalent combination of education and experience.
Three years of progressive experience in provider enrollment, credentialing, or healthcare payer relations.
Demonstrated expertise in Medicare, Medicaid, and commercial payer enrollment processes, including initial applications, revalidations, and ongoing maintenance.
Hands-on experience using provider data systems such as CAQH ProView, PECOS, NPPES, Availity, and payer-specific portals.
Proven track record of independently managing high-volume, complex enrollment cases with accuracy and timeliness.
Experience researching and resolving escalated enrollment issues, discrepancies, or payer denials.
Ability to interpret and apply CMS and state-specific regulations as they relate to provider enrollment and compliance.
Proficiency with Microsoft Office Suite and credentialing/enrollment databases.
Strong written and verbal communication skills with experience interacting directly with providers, payer representatives, and internal leadership.
Demonstrated ability to maintain compliance with HIPAA and other regulatory requirements.

Nice To Haves

Experience training, mentoring, or supporting junior staff a plus.

Responsibilities

Independently research and interpret complex payer enrollment requirements, including state-specific and specialty requirements.
Complete and manage high-volume and escalated enrollment applications, ensuring timely and accurate submission through completion.
Lead the review, research, and resolution of escalated emails, tickets, and payer inquiries, serving as a subject matter resource.
Oversee revalidation/recredentialing processes for complex provider groups or multistate enrollments.
Manage and submit updates to remittance and practice addresses, including payer-specific forms and compliance requirements.
Support payer conversion and process improvement initiatives, providing recommendations based on enrollment trends.
Communicate proactively with key stakeholders, leadership, and clients regarding risks, delays, or compliance concerns in assigned work.
Build and foster strong, collaborative relationships with payer representatives, providers, and internal teams to support successful enrollment cycles.
Provide guidance, support, or mentoring to Provider Enrollment Specialist team members as needed.
Contribute to workflow optimization and best practice development within the enrollment team.
Other duties as assigned.

Benefits

Medical
Dental/Orthodontia
Vision
Employee Assistance Program (includes counseling, legal resolution, financial education, pet adoption assistance, identity theft and fraud resolution)
Flexible work scheduling
Generous Paid Time Off (PTO) plan
Learning program foundation for career development
Team building events (family company picnic, holiday party)
Competitive pay
Quarterly bonuses
401(k) retirement plan with an employer match