Enrollment Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Submit and monitor clinician enrollment requests with various health plans in accordance with plan-specific requirements and timelines.

• Create, quality-check, and submit ongoing clinician rosters utilizing Google Sheets and Excel.

• Confirm names, tax IDs, licenses, practice locations, and dates prior to submissions.

• Reconcile roster and enrollment records between internal systems and files provided by plans.

• Resolve discrepancies through lookups, filters, de-duplication, and multi-tab formulas.

• Process requests for adding or removing health plans or state licenses.

• Oversee clinician terminations and plan unenrollments, ensuring accurate end dates.

• Track enrollment status and turnaround times; escalate any delays and risks.

• Engage in communication with clinicians and health plan representatives.

• Utilize AI tools for automation, data analysis, and work verification.

• Enhance and automate the roster submission process while upholding current procedures.

• Address provider inquiries by collaborating with cross-functional teams.

• Assist with payer escalations and claims investigations using enrollment data.

• Update the Alma Portal to align with roster data and collaborate with Product to rectify errors.

• Generate monthly executive-level reports regarding roster and waitlist accuracy.

⛳️ Requirements

• A minimum of 2 years of direct experience in provider enrollment and rostering with commercial health plans, supporting a large, multi-state group practice or clinician network.

• Familiarity with health plan enrollment and roster submission requirements, including applications, roster files, effective dates, and terminations.

• Experience in improving or automating roster submission or enrollment workflows.

• Exceptional attention to detail and the ability to perform self-checks against source data.

• Advanced skills in Google Sheets and Excel, including lookup functions, pivot tables, conditional formatting, and multi-tab formulas.

• Capability to clean, compare, and audit large data sets with precision.

• Clear and professional written communication skills with clinicians, health plans, and internal stakeholders.

• Ability to independently manage recurring, deadline-driven processes and escalate issues promptly.

• Working knowledge of Google Workspace applications, such as Docs, Sheets, Slides, and Forms.

• Proven regular use of AI tools for drafting, analyzing, and validating work, including effective prompting and output assessment.

• A proactive mindset towards process improvement and a readiness to learn new systems quickly.

• Preferred: experience with national and regional health plans, behavioral health or healthcare revenue cycles, spreadsheet scripts or lightweight automations, or professional credentials such as CPCS or CPMSM.

🏝️ Benefits

• Health, dental, and vision benefits starting from day one.

• One Medical accounts available for employees and their dependents.

• HSA and FSA plans, with Spring contributing up to $1,000 to HSAs based on plan type.

• Employer-sponsored 401(k) match of up to 2%.

• Annual allotment of no-cost visits to Spring Health therapists, coaches, and medication management providers for employees and their dependents.

• Paid vacation, sick leave, and company holidays.

• Parental leave after 6 months: 18 weeks for birthing parents and 16 weeks for non-birthing parents.

• Noom weight management program available.

• Carrot fertility care support, including reimbursement of up to $4,000 for related fertility expenses.

• Wellhub subscription covering fitness, mindfulness, nutrition, and sleep.

• BrightHorizons sponsored child care, backup care, and elder care services.

• Up to $1,000 annual reimbursement for professional development.

• $200 per year in donation matching.