Provider Data Remote Jobs (NOW HIRING)

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.

Remote:Experity offers Team Members the opportunity to work remotely or in an office.

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

#LI-REMOTE