Provider Enrollment and Onboarding Specialist

Employment Status: Full-Time

FLSA Status: Non-Exempt

Location: 1000 NW 65th Street Suite 300D Fort Lauderdale, FL 33309

Work Location: On Site

Work Hours: 8AM – 4:30 PM Monday to Friday

Job Summary:

As a Provider Enrollment and Onboarding Specialist, you will be responsible for managing the process of provider enrollment and onboarding for our organization, ensuring that our healthcare providers are properly qualified and enrolled with insurance networks.

Duties and Responsibilities:

• Manage all aspects of the provider enrollment and onboarding process, including initial applications, re-credentialing, and maintaining provider information in all necessary systems.
• Performs primary source verification of provider credentials, including education, training, licensure and certifications
• Coordinates with insurance payers to complete provider enrollment applications
• Manages delegated credentialing agreements, ensuring that our internal processes meet insurance company standards.
• Works with healthcare providers to complete necessary paperwork and answer questions about the enrollment and credentialing process.
• Stays up to date with changes in regulations and standards from organizations such as the National Committee for Quality Assurance (NCQA), The Joint Commission (TJC), and the Centers for Medicare and Medicaid Services (CMS).
• Maintains accurate records and ensures that all credentialing documents are current and comply with industry standards
• Handles provider privilege process, collaborating with the medical staff office when needed.
• Works collaboratively with other departments to resolve credentialing and enrollment issues
• All other duties as assigned

Required Skills/Abilities:

• 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
• Experience in a managed care setting is preferred

Education and Experience:

• High school diploma or equivalent required; Associate or Bachelor's degree in Healthcare administration, or the equivalent experience
• Minimum of 3 years of experience in provider enrollment, credentialing or a related field

Benefits:

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