Provider Enrollment Specialist

Summary

Join Infinx, a rapidly growing technology company providing innovative solutions to healthcare providers. As a Provider Enrollment Specialist, you will coordinate provider participation in health insurance networks, ensuring timely and compliant enrollment and re-enrollment. You will review provider data for accuracy, resolve enrollment issues, and maintain positive relationships with providers and payers. This fully remote role requires strong organizational, communication, and problem-solving skills, along with experience in physician medical practices and payer credentialing. Infinx offers a comprehensive benefits package including medical, dental, vision, 401k, paid time off, and more.

Requirements

• High School Diploma or equivalent
• 3 years of experience in a physician medical practice with a basic understanding of various payer billing requirements and claims processing or experience with payer credentialing/enrollment requirements
• Experience with provider enrollment auditing and quality assurance
• Experience with California Medicaid enrollments
• Proficiency in Microsoft Word, Excel, Outlook, PDF Software and other management tools
• Be motivated to quickly learn and demonstrate strong problem-solving skills
• Possess strong project management and multitasking skills
• Possess excellent interpersonal and communication skills
• Possess strong writing skills and attention to detail
• Possess strong organizational skills and ability to be attentive to details

Responsibilities

• Complete provider payer enrollment/credentialing and recredentialing with all identified payers in a timely manner
• Resolve enrollment issues through collaboration with physicians, non-physicians, office staff, management, contracting, insurers, and others as identified. Maintain positive working relationships with providers
• Play an active role in explaining to providers and practice/office managers the submission requirements for credentialing/recredentialing processes, stressing the importance of compliance with these processes
• Obtain updated provider information from various sources including provider offices, state licensing boards, malpractice insurance companies, residency training programs, etc
• Identify and resolve problems with primary source verification elements by interpreting, analyzing, and researching data
• Proactively obtain updated provider credentialing data prior to expiration. Create, develop, and maintain applicable matrices and/or utilize departmental software that supports the enrollment functions. Complete all additions, updates, and deletions. Support new provider onboarding processes as related to enrollment
• Communicate updated payer enrollment information including payer provider numbers to practice operations in a timely manner while fostering working relationships and teamwork with departments, vendors, etc
• Develop databases and spreadsheets for tracking organization providers. Ensure data is accessible/transparent for executive inquiries or other information as deemed necessary by management
• Continuously search for process improvements to achieve accuracy and efficiencies
• Perform other duties as assigned or required

Preferred Qualifications

Demonstrated knowledge of healthcare contracts

Benefits

• Access to a 401(k) Retirement Savings Plan
• Comprehensive Medical, Dental, and Vision Coverage
• Paid Time Off
• Paid Holidays
• Additional benefits, including Pet Care Coverage, Employee Assistance Program (EAP), and discounted services
• Flexible work hours when possible