• Review and process initial provider enrollment applications per State requirements • Updates provider changes, certifications, and license updates • Navigates multiple systems, licensing and medical certification websites to obtain updates • Follows up with providers on outstanding issues within contractual guidelines • Provides excellent customer service with professional verbal and written abilities while meeting documented quality standards

Role Description A5 Healthcare (Anders Affiliate) is seeking a Senior Provider Enrollment Specialist 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. 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. What You’ll Do: - Advanced Provider Enrollment and Credentialing: - Lead the submission and oversight of complex and high-priority initial applications, reappointments, and recredentialing efforts. - Conduct quality assurance reviews of credentialing documents and workflows to ensure accuracy and compliance. - Serve as the primary liaison with health plans on escalated or time-sensitive enrollment matters. - Oversee and improve payer tracking systems and credentialing databases; ensure all data is accurately maintained. - Identify and address systemic issues in enrollment processes, recommending and implementing best practices. - Support audits and accreditation activities by compiling data and documentation as needed. - Assist leadership in developing policies and procedures for credentialing and payer enrollment functions. - Team Support and Leadership: - Provide mentorship and training to Payer Enrollment Specialists and new team members. - Support team workload balancing by assisting in complex case management and troubleshooting. - Collaborate cross-functionally with internal stakeholders such as compliance, provider relations, and operations. - Represent the credentialing team in interdepartmental meetings and projects. - General Responsibilities: - Maintain in-depth knowledge of evolving payer policies, credentialing regulations, and accreditation standards. - Analyze data and produce reports on credentialing metrics and trends. - Participate in continuous improvement initiatives and credentialing software optimization. - Promote a collaborative, high-performance culture in a fully remote or hybrid team environment. Qualifications - Proven leadership ability and experience mentoring or training junior staff. - Advanced understanding of credentialing workflows, payer enrollment requirements, and regulatory compliance. - High-level organizational and problem-solving skills with keen attention to detail. - Excellent written and verbal communication; capable of handling sensitive issues with professionalism. - Proficient in credentialing and enrollment systems, with strong Excel and Microsoft Office Suite skills. - Self-directed, accountable, and capable of managing priorities in a fast-paced remote environment. Requirements - Associate’s degree required; Bachelor’s degree in healthcare administration or a related field preferred. - Minimum 3–5 years of experience in payer enrollment or healthcare credentialing, including experience with NCQA, URAC, and CMS standards. - Certification as a Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medical Services Management (CPMSM) is strongly preferred. - Applicants to the Senior Provider Enrollment Specialist position must be located within the Tulsa, OK area. Benefits - Collaborative culture that makes you feel part of the team from day one. - Professional development opportunities. - Benefits that directly impact mental, physical, and financial wellness. - Work Flex program allowing for remote, hybrid, or office work options.

Role Description The Team Lead, Provider Enrollment is responsible for training and oversight of offshore team members and assisting the provider enrollment manager to ensure the credentialing/enrolling of new and established health care providers and other policies/procedures of the department are being followed. - Assist in the oversight of issue resolution for the provider education process regarding application completion and submission. - Assist in the oversight of ensuring that the collection, updating and maintenance of necessary provider information and documentation is completed. - Assist in ensuring the enrollment follow-up, by client and payer, is completed within departmental and client parameters. - Ensure that provider enrollment applications for all initial applications and re-credentialing are completed in a timely and complete manner. - Assist in the oversight to ensure that verification of provider and group information with insurance companies is completed. - Assist in the coordination of information for enrollment and termination of all providers and communicate to team and clients as appropriate. - Contributes to the departmental process and procedures with a collaborative approach. - Assist in the oversight of the monitoring of provider enrollment work queues and smart feeds and other provider reports to ensure they are kept current and communicate areas of opportunities and trends to the Manager. - Assist in the training and education on enrollment processes or required research for accuracy. - Organizes, schedules and conducts all training activities of the onshore and offshore provider enrollment team as it relates to enrollment follow-up. - Documents and records training sessions to be used for future reference. - Monitors and analyzes productivity along with performing Q/A for offshore team. - Provides timely feedback to offshore provider enrollment regarding Q/A process and results. - Identify struggles with offshore provider enrollment staff and provide guidance when needed. - Performs other duties as requested. - Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards. - Understand and comply with Information Security and HIPAA policies and procedures at all times. - Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties. Qualifications - High School graduate or equivalent required. - 4 years of provider enrollment experience. - Knowledge of Microsoft Word, Outlook, Excel, CAQH. - Billing knowledge and experience preferred. - Strong organizational skills and the ability to prioritize work. - Excellent written, verbal and interpersonal skills. - Proficiency in Microsoft Office Suite. - Strong interpersonal skills, ability to communicate well at all levels of the organization. - Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses. - High level of integrity and dependability with a strong sense of urgency and results oriented. - Excellent written and verbal communication skills required. - Gracious and welcoming personality for customer service interaction. Requirements - Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes. Company Description Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

• Works in conjunction with the Provider Enrollment Manager to identify Provider Payer Enrollment issues or denials. • Researches, resolves, and enrolls any payer issues, utilizing a variety of proprietary and external tools. • Contacts clients, operations personnel, and Centers for Medicare & Medicaid Services (CMS) via phone, email, or website. • Performs follow-up with market locations to research and resolve payer enrollment issues. • Manages the completion and submission of CMS Medicare, State Medicaid and any other third-party payer applications. • Maintains documentation and reporting regarding payer enrollments in process. • Establishes close working relationships with Clients, Operations, and Revenue Cycle Management team.