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Provider Enrollment Specialist II - Full Time - Hybrid

$19.1 - $22.5 per hour
Full-time

Experity

Experity is a mission-driven team transforming on-demand healthcare across the U.S., empowering urgent care clinics with industry-leading software that makes care faster, easier, and more patient-focused. Joining us means doing meaningful work that directly improves the healthcare experience for millions—from helping families access care quickly to ensuring clinics run smoothly behind the scenes. If you want to make a real impact alongside innovative, dedicated teammates while contributing to a trusted platform that’s becoming the operating system for on-demand care, Experity is the place to grow your career. Experity offers the following: 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. Flexibility – Experity is committed to helping team members face the demands of juggling work, family and life-related issues by offering flexible work scheduling to manage your work-life balance. 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. Compensation: Budgeted between $19.10 and $22.50 dependent upon applicable experience. Hybrid: Experity offers Team Members the opportunity to work remotely or in an office. While this position allows remote work, we require Team Members to live within a commutable distance from one of our locations to ensure you are available to come into the office as needed. 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. Education and Experience: Associate's degree or equivalent combination of education and experience. Three years of progressive experience in provider enrollment, credentialing, or healthcare payer relations. Demonstrated expertise in Medicare, Medicaid, and commercial payer enrollment processes, including initial applications, revalidations, and ongoing maintenance. Hands-on experience using provider data systems such as CAQH ProView, PECOS, NPPES, Availity, and payer-specific portals. Proven track record of independently managing high-volume, complex enrollment cases with accuracy and timeliness. Experience researching and resolving escalated enrollment issues, discrepancies, or payer denials. 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. Strong written and verbal communication skills with experience interacting directly with providers, payer representatives, and internal leadership. Demonstrated ability to maintain compliance with HIPAA and other regulatory requirements. Experience training, mentoring, or supporting junior staff a plus. Every team member exhibits our core values: Team First Lift Others Up Share Openly Set and Crush Goals Delight the Client Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. At Experity we're committed to changing on-demand healthcare for the better with innovative advancements that keep patients at the center of the solutions we build and the services we provide. We share that same level of commitment to providing a postive workplace where out team can develop and thrive to become leaders in the healthcare industry. At Experity we lift eachother up and put our teams first, encourage each other to share openly, and work together to set and crush our goals. United by these values, we know where we want to go and how to get there.

Vacancy posted 3 days ago
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