Provider Enrollment Specialist

MDVIP LLC • Boca Raton, FL

155d

About The Position

MDVIP is a national leader in personalized healthcare, empowering over 425,000 members to achieve their health and wellness goals through a network of more than 1,400 concierge primary care physicians. Our program emphasizes preventive medicine, offering comprehensive screenings, advanced diagnostics, and individualized wellness plans. Recognized as a Great Place to Work® since 2018, MDVIP is committed to excellence in patient care and employee satisfaction. The role involves managing the insurance credentialing/re-credentialing process, providing guidance, and resolving complex issues. The position requires coordination with various stakeholders and the preparation of reports for management.

Requirements

• Associate degree and at least two years related business experience.
• Strong understanding of the MDVIP model.
• Proven experience in a similar corporate role focused on coordination or management of credentialing processes.
• Insurance experience and healthcare knowledge preferred.
• Ability to develop thorough knowledge of CAQH, PECOS & NPPES applications.
• Experience with CRM, EMR, and/or credentialing software required.
• Proficient in Microsoft Office applications.

Nice To Haves

• Certified Provider Credentialing Specialist (CPCS) highly desired.

Responsibilities

• Coordinates all aspects of the credentialing process while delivering top quality customer service.
• Enters all pertinent data from applications into credentialing system and runs daily and weekly reports.
• Maintains credentialing system processes, and policy and procedures, ensuring adherence to all requirements.
• Represents doctors and companies interests while interfacing with insurance carriers and regulatory bodies.
• Identifies pertinent credentialing matters and provides analysis and resolution to Management weekly.
• Establishes and communicates timelines with MDVIP affiliates to ensure schedules are met.
• Prepares, reviews, and sends status reports on an as needed basis to affiliated physicians and field staff.
• Creates and communicates physician credentialing status report(s) to internal Management in monthly meetings.
• Assesses all credentialing related materials and coordinates with outside professional staff.
• Provides analysis and recommendations to Management for escalated transition issues.
• Provides training and guidance to affiliates or respective billing companies related to MDVIP.

Benefits

• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree
• Number of Employees: 251-500 employees