Pediatrix Medical Group
5001 - 10000 employees
Founded 1979
🏥 Healthcare
🤝 B2B
Healthcare • B2B
Pediatrix Medical Group is a physician-led national provider of specialized prenatal, neonatal and pediatric clinical services. The company delivers in-person and virtual care (including TeleNICU, TeleMFM, TeleNeurology, TeleROP and other telehealth offerings), partners with hospitals to provide customized clinical solutions, and supports clinicians through operations, technology, education, and research. According to its materials it operates in 37 states, partners with nearly 400 hospitals, and works with 4,300+ affiliated clinicians, offering services such as prenatal care, maternal-fetal medicine, neonatal intensive care, pediatric specialty and critical care, and accredited continuing education and a Center for Research, Education, Quality and Safety.
Provider Enrollment Specialist
🔥 24 minutes ago
Where this job comes from
Posted on Pediatrix Medical Group's careers page, not through a job board
First seen by Remote Rocketship 24 minutes ago
Pediatrix Medical Group
5001 - 10000 employees
Founded 1979
🏥 Healthcare
🤝 B2B
Healthcare • B2B
Pediatrix Medical Group is a physician-led national provider of specialized prenatal, neonatal and pediatric clinical services. The company delivers in-person and virtual care (including TeleNICU, TeleMFM, TeleNeurology, TeleROP and other telehealth offerings), partners with hospitals to provide customized clinical solutions, and supports clinicians through operations, technology, education, and research. According to its materials it operates in 37 states, partners with nearly 400 hospitals, and works with 4,300+ affiliated clinicians, offering services such as prenatal care, maternal-fetal medicine, neonatal intensive care, pediatric specialty and critical care, and accredited continuing education and a Center for Research, Education, Quality and Safety.
📋 Description
• Enroll practitioners in health plans accurately and timely • Monitor enrollment progress and ensure completion timelines • Provide enrollment updates to appropriate RCM central business offices • Assist Management in maintaining provider enrollment goals for all divisions • Validate current plan enrollment forms, complete applications, submit them to health plans, and follow up until enrollment is complete • Verify accuracy and coordinate entry of provider information into IntelliCred and the Master Database • Map forms in IntelliCred, prioritize work, and research health plan enrollment requirements • Document assignments in the Credentialing/Provider Enrollment tracking system • Contact health plans to determine enrollment requirements and verify specialty-specific requirements • Prepare and review group applications for acquisitions, Tax ID mergers, and Organic Growth Initiatives • Communicate with Business Development, Business Integration, and Credentialing to obtain required documents and signatures • Maintain provider profiles in the Provider Enrollment tracking system and CAQH • Monitor delegated agreement health plan enrollment reports and aging reports • Validate onboarding enrollment status to meet Target Start Dates • Escalate enrollment issues to Provider Enrollment Management when necessary • Perform other job-related duties within scope as requested by Provider Enrollment Management
🎯 Requirements
• Associate's degree (A. A.) or equivalent from two-year college or technical school • Three (3) or more years related experience or equivalent combination of education and experience • Knowledge of Group Entity health plan enrollments, state regulations and appeal processes • Knowledge of Provider Enrollment policies and procedures • Ability to read, analyze, and interpret common and technical journals, financial reports, and legal documents • Ability to respond to inquiries or complaints from customers, regulatory agencies, or members of the business community • Ability to write speeches and articles for publication conforming to prescribed style and format • Ability to present information to top management, public groups, and/or boards of directors • Ability to work with probability, statistical inference, plane and solid geometry, and trigonometry • Ability to apply fractions, percentages, ratios, and proportions to practical situations • Ability to define problems, collect data, establish facts, and draw valid conclusions • Ability to interpret technical instructions in mathematical or diagram form and deal with abstract and concrete variables • Understanding of medical terminology and protocols • Experience with Excel, Word, Adobe Professional, Pediatrix Master Database, OnBase, WorkView, hCue, CAQH, and IntelliCred
🏖️ Benefits
• Medical insurance • Dental insurance • Vision insurance • Life insurance • Disability insurance • Healthcare FSA • Dependent Care FSA • HSAs • 401k plan • Employee Stock Purchase Program • Voluntary benefit plans • Payroll deductions for benefits
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