Provider Enrollment Specialist II - Full Time - Remote

Responsibilities

• Independently research and interpret complex payer enrollment requirements, including state-specific and specialty requirements.
• Complete and manage high-volume and escalated enrollment applications, ensuring timely and accurate submission through completion.
• Lead the review, research, and resolution of escalated emails, tickets, and payer inquiries, serving as a subject matter resource.
• Oversee revalidation/recredentialing processes for complex provider groups or multistate enrollments.
• Manage and submit updates to remittance and practice addresses, including payer-specific forms and compliance requirements.
• Support payer conversion and process improvement initiatives, providing recommendations based on enrollment trends.
• Communicate proactively with key stakeholders, leadership, and clients regarding risks, delays, or compliance concerns in assigned work.
• Build and foster strong, collaborative relationships with payer representatives, providers, and internal teams to support successful enrollment cycles.
• Provide guidance, support, or mentoring to Provider Enrollment Specialist team members as needed.
• Contribute to workflow optimization and best practice development within the enrollment team.
• Other duties as assigned.

Requirements

• Absolutely no requirements listed.

Qualifications

• Absolutely no qualifications listed.

Skills

• Strong written and verbal communication skills
• Ability to interpret and apply CMS and state-specific regulations as they relate to provider enrollment and compliance
• Proficiency with Microsoft Office Suite and credentialing/enrollment databases
• Hands-on experience using provider data systems such as CAQH ProView, PECOS, NPPES, Availity, and payer-specific portals
• Experience researching and resolving escalated enrollment issues, discrepancies, or payer denials
• Proven track record of independently managing high-volume, complex enrollment cases with accuracy and timeliness

Benefits

• Comprehensive coverage starts first day of employment and includes Medical, Dental/Orthodontia, and Vision.
• Ownership - All Team Members are eligible for synthetic ownership in Experity upon one year of employment with real financial rewards when the company is successful!
• Employee Assistance Program - This robust program includes counseling, legal resolution, financial education, pet adoption assistance, identity theft and fraud resolution, and so much more.
• Paid Time Off (PTO) - Experity offers a generous PTO plan and increases with milestones to ensure our Team Members have time to recharge, relax, and spend time with loved ones.
• Career Development – Experity maintains a learning program foundation for the company that allows Team Members to explore their potential and achieve their career goals.
• Team Building – We bring our Team Members together when we can to strengthen the team, build relationships, and have fun! We even have a family company picnic and a holiday party.
• Total Compensation - Competitive pay, quarterly bonuses and a 401(k) retirement plan with an employer match to help you save for your future and ensure that you can retire with financial security.

Pay

Budgeted between $19.10 and $22.50 dependent upon applicable experience.

Schedule

Remote: Experity offers Team Members the opportunity to work remotely or in an office.