Provider Enrollment Specialist at MDVIP LLC

Boca Raton, Florida, United States -

Full Time

Start Date

Immediate

Expiry Date

31 Jan, 26

Salary

0.0

Posted On

02 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Credentialing, Customer Service, Data Analysis, Communication, Problem Solving, Collaboration, Microsoft Office, EMR Software, Credentialing Software, CAQH, PECOS, NPPES, Salesforce, Training, Regulatory Compliance, Strategic Thinking

Industry

Wellness and Fitness Services

Description

Position Location This role is a corporate based role in Boca Raton, FL, but may be eligible for a hybrid model. MDVIP Overview MDVIP: Transforming Primary Care, One Patient at a Time 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. Position Summary MDVIP is seeking a Provider Enrollment Specialist, reporting to the Sr. Manager of Insurance Programs, to manage the insurance credentialing and re-credentialing process for our MDVIP physician affiliates. This role requires a deep understanding of credentialing procedures and the ability to provide accurate guidance and support to affiliated physicians and internal teams. If you have a thorough understanding of managing insurance credentialing and are a critical thinker, we want to meet you. You’ll coordinate with and support the Insurance Services Department in the resolution of complex or advanced issues and cases. As the Provider Enrollment Specialist, you’ll serve as a liaison between MDVIP and insurance carriers, commercial and federal clearinghouses, and regulatory bodies at the state, county, and federal levels. Additionally, you will ensure compliance with all licensing and credentialing requirements on behalf of MDVIP affiliated physicians. Key Responsibilities Credentialing Coordination • Coordinate all aspects of the credentialing process while delivering top quality customer service. • Maintain credentialing system processes, policy and procedures, ensuring adherence to all requirements and taking corrective steps as needed. • Serve as a liaison between physicians, MDVIP staff, and external entities—including insurance carriers, clearinghouses, and licensing agencies—to support all aspects of the credentialing process. • Identify pertinent credentialing matters and provide analysis and resolution to Management weekly. Metrics & Reporting • Establish and communicate timelines with MDVIP affiliates to ensure schedules are met. Work directly with stakeholders to overcome roadblocks. • Prepare, review, and send status reports to affiliated physicians and field staff, follow-up to ensure closure on outstanding cases. • Create and communicate physician credentialing status reports to internal Management in monthly meetings. • Compile, run, and complete various insurance related reports and presentations for Management. Escalation & Urgent Issues • Assess all credentialing related materials and reports, and coordinate with external stakeholders to verify all outside processes are completed. • Provide analysis and recommendations to Management for escalated transition issues. Resolves escalated issues and assists with urgent requests. • Provide training and guidance to affiliates or respective billing companies related to MDVIP, when requested, on preventive billing protocols and/or credentialing needs. Key Competencies • Successful track record in a similar corporate role focused on coordination or management of credentialing/re-credentialing processes for primary physicians. • Interprets complex data using experience and intuition to support insights. • Builds collaborative, productive relationships with physicians 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. Minimum Qualifications • Associate’s degree and at least two (2) years related business experience. • Familiarity with EMR and credentialing software. • Proficient in Microsoft Office applications. Preferred Qualifications • Experience with CAQH, PECOS & NPPES applications. • Experience with Net Docs, credentialing software, and athena. • Certified Provider Credentialing Specialist (CPCS). • Experience with Salesforce or other CRM tools. ‎ Why Join MDVIP? • Be part of a mission-driven organization leading innovation in personalized healthcare.• Drive transformation and growth in a dynamic, fast-paced environment.• 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.• Positive work environment: consistently recognized as a Great Place to Work®, fostering a culture of collaboration and excellence. MDVIP is an Equal Opportunity Employer and is committed to fostering an inclusive and diverse workplace. We welcome applicants of all backgrounds and do not discriminate based on race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected status. We believe that diversity and inclusion drive innovation and strengthen our company culture. If you require accommodation during the application or interview process, please let us know, and we will be happy to assist. ‎ Our compensation reflects the cost of labor across appropriate US geographic markets. Pay is based on several factors including but not limited to market location and may vary depending on job-related knowledge, skills, and education/training and a candidate's work experience. Hired applicants are offered annual incentive compensation programs, subject to applicable eligibility requirements. Payments under these annual programs are not guaranteed and are dependent upon a variety of factors including, but not limited to, individual performance, business unit performance, and/or the company's performance. The company offers the following benefits for this position, subject to applicable eligibility requirements. 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.

Responsibilities

The Provider Enrollment Specialist will manage the insurance credentialing and re-credentialing process for MDVIP physician affiliates. This role involves coordinating with various stakeholders to ensure compliance with licensing and credentialing requirements.