Enrollment Specialist (Remote) in Palm Springs, Florida at PBACO Holding LLC

Measurable Goals/Objectives:

Maintain 98% or greater accuracy for roster data, submission files, enrollment records, and reports.Complete scheduled roster submissions and assigned enrollment transactions by established internal and payor deadlines.Reconcile submission results and payor rosters within established turnaround times, documenting and resolving identified discrepancies.Provide timely, accurate status updates and follow-up to practice credentialing contacts and internal stakeholders on open enrollment items.

Supervisory Responsibilities: None.

Competencies: To perform the job successfully, an individual should demonstrate the following competencies:

Strong attention to detail, accuracy, data quality, and follow-through.Working knowledge of provider enrollment, payor roster processes, provider demographics, and healthcare data requirements.Ability to organize and prioritize recurring submissions, report schedules, deadlines, and stakeholder requests in a fast-paced environment.Ability to analyze roster reports, reconcile data from multiple sources, identify trends, and resolve discrepancies.Professional communication and relationship-management skills with practice credentialing contacts, payors, vendors, and internal departments.Ability to maintain confidentiality and handle sensitive information appropriately.Proficiency with Microsoft Excel and other Office applications, enrollment databases, payor portals, reporting tools, and electronic file management systems.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience: High school diploma or equivalent required; Associate’s or Bachelor’s degree in Healthcare Administration, Business, or a related field preferred. Minimum of 2–3 years of experience in provider enrollment, payor roster management, credentialing operations, healthcare administration, managed care, medical group operations, or a related healthcare setting preferred. Experience preparing and submitting payor rosters, reconciling provider data, tracking enrollment transactions, and working with practice credentialing contacts is preferred.