You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
Our client is seeking a Provider Enrollment Specialist responsible for overseeing payer enrollment and credentialing-related claim denials, supporting revenue cycle functions, and ensuring smooth provider enrollments in alignment with executed payer agreements.
Key Responsibilities
- Serve as the subject matter expert for payer enrollment and credentialing-related claim denials.
- Review and work enrollment-related denials from Revenue Cycle teams to identify root causes and implement corrective actions.
- Research payer denials involving provider participation, effective dates, credentialing status, taxonomy, billing group assignments, contracting discrepancies, or enrollment errors.
- Coordinate timely claim corrections and resubmissions after enrollment issues have been resolved.
- Collaborate with the Contracting team to ensure provider enrollments align with executed payer agreements and contract effective dates.
- Assist in coordinating payer implementations for newly executed contracts and acquisitions.
Qualifications
- Minimum 2 years of provider enrollment experience.
- Minimum 2 years of Revenue Cycle Management (RCM), billing, accounts receivable, or payer denial resolution experience.
- Strong understanding of Medicare, Medicaid, and commercial payer enrollment requirements.
- Experience working with provider enrollment systems, payer portals, and credentialing software.
Skills
- Proficiency with CAQH ProView, PECOS, NPPES, and payer-specific enrollment systems.
- Working knowledge of provider contracting and payer implementation processes.
Hours Per Week
40 hours per week
Additional Requirements
Standard work schedule is Monday to Friday, from 8:30am to 5:00pm.
Benefits
- Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
- Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
- 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
- Short Term Disability Insurance.
- Term Life Insurance Plan.
Required Employment / Compliance Language
*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
