MDVIP · 1 day ago
Provider Enrollment Analyst
Boca Raton, FL, US
Full-time
Onsite
Mid Level
4+ years expMDVIP is a national leader in personalized healthcare, empowering members to achieve their health and wellness goals through a network of concierge primary care physicians. The Provider Enrollment Analyst will manage the insurance provider enrollment process, ensuring compliance with licensing and credentialing requirements while serving as a liaison between MDVIP and insurance carriers.
Health CareMedical
Responsibilities
Manages non-standard provider enrollment workflows, interpreting payer-specific contract requirements and independently navigating complex scenarios that fall outside templated enrollment processes
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 as operational challenges arise
Serves as the primary liaison and subject‑matter expert for provider enrollment, collaborating across physicians, internal stakeholders, and external partners to drive alignment, quality, operational readiness, and a consistently high standard of service across credentialing and contracting workflows
Complete statewide credentialing applications to establish new groups and add providers to commercial payers and Medicare
Serves as the authoritative steward of provider enrollment data. Conducts detailed analysis and reconciliation of provider enrollment information across multiple systems, proactively identifying discrepancies, downstream risks, and potential impacts to revenue, access, or compliance
Maintain 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 clearly 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
Provide training and guidance to affiliates, physician staff or respective billing companies related to MDVIP, when requested, on preventive billing protocols and/or provider enrollment needs
Develop, analyze, and distribute timely status reports to affiliated physicians and field staff; proactively manage follow-ups to ensure resolution and closure of all outstanding cases
Compile, validate, and deliver comprehensive insurance related reports and management presentations, translating complex data into clear insights to support decision making and operational planning
Conducts detailed analysis and reconciliation of provider enrollment data to support accurate contracting, payer submissions, and ongoing network compliance, while managing complex, non-standard enrollment scenarios
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
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
Qualification
Required
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
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
Benefits
Health, dental, vision insurance, and retirement plans
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
Company
MDVIP
MDVIP was founded as an alternative to a primary healthcare system characterized by long wait times and overextended physicians.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
unknown2021-08-19Acquired
2004-12-23Private Equity
Leadership Team
J
John Kane
Chief Technology Officer
J
Jessica Jacobs
Chief Marketing Officer
Recent News
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