Senior Provider Enrollment Specialist

<p><span style="font-size: 12pt;">A5 Healthcare (Anders Affiliate) one of the fastest-growing Credentialing Verification Organizations in the country is seeking a <strong>Senior Provider Enrollment Specialist</strong> who is motivated to learn, excited to collaborate and passionate about delivering outstanding results. This individual will have a direct impact on our firm’s mission of serving as a catalyst for those striving to achieve their highest potential. </span></p> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">The Senior Provider Enrollment Specialist at A5 Services serves as a key leader in the credentialing and payer enrollment function for the Independent Physician Association (IPA). This advanced role is responsible for overseeing and executing complex enrollment processes, ensuring compliance with NCQA, URAC, and CMS accreditation standards, and providing mentorship and guidance to junior staff. The Senior Specialist acts as a subject matter expert and strategic partner across departments and with external payers to streamline and enhance the credentialing workflow. This position plays a critical role in maintaining operational excellence, regulatory compliance, and provider satisfaction.</span></p> <p> </p> <p><span class="NormalTextRun SCXW44593987 BCX9" style="font-size: 12pt; font-family: arial, helvetica, sans-serif; color: rgb(0, 0, 0);" data-ccp-charstyle="eop" data-ccp-charstyle-defn="{"ObjectId":"706c6be7-4c96-4dc1-adeb-1798e723ddef|151","ClassId":1073872969,"Properties":[469775450,"eop",201340122,"1",134233614,"true",469778129,"eop",335572020,"1",469778324,"Default Paragraph Font"]}"><strong><span class="TextRun SCXW81298237 BCX9" lang="EN-US" data-contrast="none"><span class="NormalTextRun SCXW81298237 BCX9" data-ccp-charstyle="normaltextrun" data-ccp-charstyle-defn="{"ObjectId":"706c6be7-4c96-4dc1-adeb-1798e723ddef|150","ClassId":1073872969,"Properties":[469775450,"normaltextrun",201340122,"1",134233614,"true",469778129,"normaltextrun",335572020,"1",469778324,"Default Paragraph Font"]}">What </span><span class="NormalTextRun SCXW81298237 BCX9" data-ccp-charstyle="normaltextrun">You’ll</span><span class="NormalTextRun SCXW81298237 BCX9" data-ccp-charstyle="normaltextrun"> Do:</span></span><span class="TextRun SCXW81298237 BCX9" lang="EN-US" data-contrast="none"><span class="NormalTextRun SCXW81298237 BCX9" data-ccp-charstyle="eop" data-ccp-charstyle-defn="{"ObjectId":"706c6be7-4c96-4dc1-adeb-1798e723ddef|151","ClassId":1073872969,"Properties":[469775450,"eop",201340122,"1",134233614,"true",469778129,"eop",335572020,"1",469778324,"Default Paragraph Font"]}"> </span></span></strong><span class="EOP SCXW81298237 BCX9" data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335559738":0,"335559739":0,"335559740":240}"> </span></span></p> <p><span style="font-size: 12pt; font-family: arial, helvetica, sans-serif;"><strong>Advanced Provider Enrollment and Credentialing</strong> </span></p> <ul> <li style="font-size: 12pt; font-family: arial, helvetica, sans-serif;"><span style="font-size: 12pt; font-family: arial, helvetica, sans-serif;">Lead the submission and oversight of complex and high-priority initial applications, reappointments, and recredentialing efforts.</span></li> <li style="font-size: 12pt; font-family: arial, helvetica, sans-serif;"><span style="font-size: 12pt; font-family: arial, helvetica, sans-serif;">Conduct quality assurance reviews of credentialing documents and workflows to ensure accuracy and compliance.</span></li> <li style="font-size: 12pt; font-family: arial, helvetica, sans-serif;"><span style="font-size: 12pt; font-family: arial, helvetica, sans-serif;">Serve as the primary liaison with health plans on escalated or time-sensitive enrollment matters.</span></li> <li style="font-size: 12pt; font-family: arial, helvetica, sans-serif;"><span style="font-size: 12pt; font-family: arial, helvetica, sans-serif;">Oversee and improve payer tracking systems and credentialing databases; ensure all data is accurately maintained.</span></li> <li style="font-size: 12pt; font-family: arial, helvetica, sans-serif;"><span style="font-size: 12pt; font-family: arial, helvetica, sans-serif;">Identify and address systemic issues in enrollment processes, recommending and implementing best practices.</span></li> <li style="font-size: 12pt; font-family: arial, helvetica, sans-serif;"><span style="font-size: 12pt; font-family: arial, helvetica, sans-serif;">Support audits and accreditation activities by compiling data and documentation as needed.</span></li> <li style="font-size: 12pt; font-family: arial, helvetica, sans-serif;"><span style="font-size: 12pt; font-family: arial, helvetica, sans-serif;">Assist leadership in developing policies and procedures for credentialing and payer enrollment functions.</span></li> </ul> <p><span style="font-size: 12pt; font-family: arial, helvetica, sans-serif;"><strong>Team Support and Leadership</strong></span></p> <ul> <li style="font-size: 12pt; font-family: arial, helvetica, sans-serif;"><span style="font-size: 12pt; font-family: arial, helvetica, sans-serif;">Provide mentorship and training to Payer Enrollment Specialists and new team members.</span></li> <li style="font-size: 12pt; font-family: arial, helvetica, sans-serif;"><span style="font-size: 12pt; font-family: arial, helvetica, sans-serif;">Support team workload balancing by assisting in complex case management and troubleshooting.</span></li> <li style="font-size: 12pt; font-family: arial, helvetica, sans-serif;"><span style="font-size: 12pt; font-family: arial, helvetica, sans-serif;">Collaborate cross-functionally with internal stakeholders such as compliance, provider relations, and operations.</span></li> <li style="font-size: 12pt; font-family: arial, helvetica, sans-serif;"><span style="font-size: 12pt; font-family: arial, helvetica, sans-serif;">Represent the credentialing team in interdepartmental meetings and projects.</span></li> </ul> <p><span style="font-size: 12pt; font-family: arial, helvetica, sans-serif;"><strong>General Responsibilities</strong></span></p> <ul> <li style="font-size: 12pt; font-family: arial, helvetica, sans-se