Enrollment Executive

The Enrollment Executive at Ethizo Doc To Me plays a vital role in managing and streamlining the enrollment process for healthcare providers. This position requires a detail-oriented and organized professional who is adept at handling provider credentialing and enrollment activities while maintaining compliance with healthcare regulations. The Enrollment Executive collaborates with multiple stakeholders, including payers and internal teams, to ensure timely and accurate processing of enrollment documentation and data. The role demands strong communication skills and the ability to multitask within a fast-paced administrative environment. Although team management is not part of this role, the incumbent is expected to work independently and contribute to the overall efficiency of the enrollment operations. This position is ideal for candidates with a background in healthcare administration or business, along with at least two years of relevant experience in healthcare enrollment, credentialing, or administrative support. Fresh graduates possessing excellent communication and organizational skills are also encouraged to apply. The role requires a solid understanding of healthcare enrollment systems such as CAQH ProView and PECOS, alongside familiarity with healthcare privacy laws such as HIPAA to safeguard Protected Health Information (PHI). Proficiency with CRM software, email automation tools, reporting, and analytics is crucial to perform data management and follow-up tasks effectively.
Responsibilities

Manage end-to-end provider enrollment processes, ensuring compliance with healthcare regulations and payer requirements.
Coordinate with healthcare providers, payers, and internal teams to gather and verify necessary documentation for credentialing and enrollment.
Utilize healthcare enrollment platforms such as CAQH ProView and the Provider Enrollment, Chain, and Ownership System (PECOS) to submit and track enrollment applications.
Maintain accurate and up-to-date records of provider data, enrollment status, and relevant documentation within CRM systems and customer data platforms.
Conduct timely follow-ups with payers and healthcare providers to expedite application processing and resolve outstanding issues.
Ensure strict adherence to HIPAA regulations by safeguarding Protected Health Information (PHI) during all stages of enrollment and documentation handling.
Generate regular reports and analytics on enrollment status, identifying trends and opportunities to improve process efficiency and accuracy.
Assist with data entry, analysis, and quality assurance to support enrollment team objectives and organizational compliance.
Communicate effectively with stakeholders to clarify enrollment requirements, resolve discrepancies, and provide updates on application progress.
Manage multiple enrollment cases simultaneously, utilizing excellent time management skills to meet deadlines without compromising quality.
Stay informed about changes in healthcare laws, payer policies, and industry best practices to proactively update enrollment procedures.
Collaborate with IT and software vendors to optimize the use of CRM software, email automation tools, and other technical resources involved in the enrollment process.
Participate in training sessions to deepen knowledge of healthcare provider enrollment and credentialing systems and processes.