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• Validates up-to-date plan enrollment forms, completes applications, submits them to plans and follows up until enrollment is complete. Verifies accuracy and coordinates entry of new and revised provider information into IntelliCred and Master Database.
• Contacts health plans to determine enrollment requirements periodically and verify health plan requirements based on the specialty and confirm the most up to date enrollment application forms are readily available in Provider Enrollment Tracking Software (IntelliCred).
• Knowledgeable with Group Entity health plan enrollments, state regulations and appeal processes. Prepares/reviews group applications based on information provided during acquisitions, Tax ID mergers, and Organic Growth Initiatives (OGI).
• Communicates with Business Development, Business Integration and Credentialing to acquire prospective new provider group's required documents and/or signatures as needed.
• Knowledgeable in reporting system functionality, mapping forms utilizing Provider Enrollment tracking software and IC system Q/A delegate.
• Maintain provider's profile in PE Tracking system (IC) with up to date with information on active or pending providers by completing all data fields in the Demographics, Appointments and Applications screen for the provider and group practice.
• Maintain provider's profile in CAQH with up to date with information on active or pending providers by completing all data fields pertaining to demographics, service locations, group entity information, required documents and expirables.
• Monitors all assigned delegated agreement health plan enrollments reports utilized to provide oversight to ensure enrollments currently assigned are being processed timely. i.e.: To Do List in IC, IntelliReports, IC Weekly aging, and IC End of Month.
• Validates status of on boarding provider's enrollments to ensure Target Start Date is met. Escalates to PE management when necessary in order to meet desired Target Start Date.
• Performs other job-related duties within the job scope as requested by Provider Enrollment Management.

• Associate's degree (A. A.) or equivalent from two-year college or technical school; or three or more years related experience and/or training; or equivalent combination of education and experience.

• Ability to read, analyze, and interpret common and technical journals, financial reports, and legal documents. Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community. Ability to write speeches and articles for publication that conforms to prescribed style and format. Ability to effectively present information to top management, public groups, and/or boards of directors.

• Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

• Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.

• Understanding of medical terminology and protocols

Benefits for Full Time employee and qualified dependents:

• Health Insurance including prescription drugs
• Dental Insurance
• Vision Insurance
• Life Insurance
• Short- and Long-Term disability options
• Employee stock purchase program - 15% discount*
• 401k with company match**
• Long Term Care (LTC)
• Pre-tax Health Savings Account (HSA)
• Pre-tax Flexible Spending Accounts (FSA)
• Aflac Hospital, Critical Illness and Accident plans
• Identity Protection
• Employee Assistance Program (EAP)

*Part Time Regular employee classifications also receive this benefit.

** Available to part-time regular and part-time casual employees age 21 and over.

Pediatrix Medical Group, Inc. (Pediatrix) is the nation's leading provider of physician services. Pediatrix-affiliated clinicians are committed to providing coordinated, compassionate and clinically excellent services to women, babies and children across the continuum of care, both in hospital settings and office-based practices. Specialties include obstetrics, maternal-fetal medicine and neonatology complemented by more than 20 pediatric subspecialties, as well as pediatric primary and urgent care clinics. The group's high-quality, evidence-based care is bolstered by significant investments in research, education, quality-improvement and safety initiatives. The physician-led company was founded in 1979 as a single neonatology practice and today provides its highly specialized and often critical care services through more than 5,000 affiliated physicians and other clinicians in 37 states.

Please Note: Fraudulent job postings/job scams are becoming increasingly common. All genuine Pediatrix job postings can be found through the Pediatrix Careers site:

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

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