Provider Enrollment Specialist
MDVIP, Boca Raton, FL, United States
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 dedicated to excellence in patient care and employee satisfaction.
Position Summary
MDVIP is looking for a
Provider Enrollment Specialist
to join our team. In this role, you will be reporting to the Manager of Insurance Programs and will oversee the insurance provider enrollment process for our MDVIP physician affiliates. A solid understanding of credentialing and contracting procedures is essential, as well as the ability to offer accurate support and guidance to affiliated physicians and internal teams. If you are a critical thinker with extensive experience in provider enrollment management, we want to hear from you! As the Provider Enrollment Specialist, you will: Manage non-standard provider enrollment workflows, interpret payer-specific contract requirements, and navigate complex scenarios independently. Coordinate end-to-end provider enrollment and contracting, ensuring high-quality service while educating physicians on timelines and managing expectations. Act as the primary liaison and expert for provider enrollment, working closely with physicians, internal teams, and external partners. Complete statewide credentialing applications to establish new groups and add providers. Conduct detailed analysis and reconciliation of provider enrollment data across multiple systems. Maintain and ensure compliance with provider enrollment policies and procedures. Provide training and guidance on preventive billing protocols related to provider enrollment needs. Metrics & Reporting Develop, analyze, and distribute timely status reports to physicians and staff, managing follow-ups for case resolution. Deliver comprehensive insurance-related reports, translating complex data into actionable insights. Escalation & Urgent Issues Analyze enrollment data to support accurate contracting and ongoing compliance. Identify and evaluate complex enrollment issues, providing root-cause analysis and actionable recommendations. Key Competencies Proven track record in coordinating or managing provider enrollment. Ability to interpret complex data and provide insights. Strong collaborative skills with physicians and stakeholders. Effective communication across diverse audiences. Proactive problem-solver committed to accountability and preparedness. Strategic thinker who can assess risks and trends for informed decisions. Minimum Qualifications Associate's degree and at least two (2) years of related business experience. Four (4) years of relevant work experience. Familiarity with EMR and credentialing software. Proficient in Microsoft Office applications. Preferred Qualifications Experience with CAQH, PECOS, and NPPES applications. Familiarity with credentialing software like Net Docs and athena. Certifications such as Certified Provider Credentialing Specialist (CPCS) or Certified Provider Enrollment Specialist (CPES). Experience with Salesforce or other CRM tools. Why Join MDVIP? Become part of a mission-driven organization that is leading innovation in personalized healthcare. Enjoy competitive compensation with performance-based incentives. Benefit from a comprehensive insurance plan, retirement options, and professional development opportunities. Be part of a positive work environment recognized for collaboration and excellence. MDVIP is an Equal Opportunity Employer
committed to an inclusive workplace. We welcome applicants from all backgrounds.
Provider Enrollment Specialist
to join our team. In this role, you will be reporting to the Manager of Insurance Programs and will oversee the insurance provider enrollment process for our MDVIP physician affiliates. A solid understanding of credentialing and contracting procedures is essential, as well as the ability to offer accurate support and guidance to affiliated physicians and internal teams. If you are a critical thinker with extensive experience in provider enrollment management, we want to hear from you! As the Provider Enrollment Specialist, you will: Manage non-standard provider enrollment workflows, interpret payer-specific contract requirements, and navigate complex scenarios independently. Coordinate end-to-end provider enrollment and contracting, ensuring high-quality service while educating physicians on timelines and managing expectations. Act as the primary liaison and expert for provider enrollment, working closely with physicians, internal teams, and external partners. Complete statewide credentialing applications to establish new groups and add providers. Conduct detailed analysis and reconciliation of provider enrollment data across multiple systems. Maintain and ensure compliance with provider enrollment policies and procedures. Provide training and guidance on preventive billing protocols related to provider enrollment needs. Metrics & Reporting Develop, analyze, and distribute timely status reports to physicians and staff, managing follow-ups for case resolution. Deliver comprehensive insurance-related reports, translating complex data into actionable insights. Escalation & Urgent Issues Analyze enrollment data to support accurate contracting and ongoing compliance. Identify and evaluate complex enrollment issues, providing root-cause analysis and actionable recommendations. Key Competencies Proven track record in coordinating or managing provider enrollment. Ability to interpret complex data and provide insights. Strong collaborative skills with physicians and stakeholders. Effective communication across diverse audiences. Proactive problem-solver committed to accountability and preparedness. Strategic thinker who can assess risks and trends for informed decisions. Minimum Qualifications Associate's degree and at least two (2) years of related business experience. Four (4) years of relevant work experience. Familiarity with EMR and credentialing software. Proficient in Microsoft Office applications. Preferred Qualifications Experience with CAQH, PECOS, and NPPES applications. Familiarity with credentialing software like Net Docs and athena. Certifications such as Certified Provider Credentialing Specialist (CPCS) or Certified Provider Enrollment Specialist (CPES). Experience with Salesforce or other CRM tools. Why Join MDVIP? Become part of a mission-driven organization that is leading innovation in personalized healthcare. Enjoy competitive compensation with performance-based incentives. Benefit from a comprehensive insurance plan, retirement options, and professional development opportunities. Be part of a positive work environment recognized for collaboration and excellence. MDVIP is an Equal Opportunity Employer
committed to an inclusive workplace. We welcome applicants from all backgrounds.