🚀 Join Pediatrix Medical Group as a Group Enrollment Specialist!

Are you a seasoned provider enrollment professional with at least 3 years experience and have passion for multi-state group enrollment? Pediatrix Medical Group — one of the nation’s largest providers of prenatal, neonatal, and pediatric services — is looking for a Group Enrollment Specialist to join our dynamic team!

In this exciting role, you’ll play a key part in ensuring our providers are enrolled efficiently and accurately across multiple states. We’re a national organization with a mission to deliver exceptional care to women and children, and we need your expertise to help us continue growing.

The Group Enrollment Specialist is responsible for coordinating and completing all group enrollment applications and Disclosure of Ownership (DOO) submissions for both government and commercial payers. This role serves as the department’s subject matter expert on group enrollment and DOO-related inquiries, ensuring compliance, accuracy, and timely processing.

Enrollment Coordination

• Research and compile payer requirements, including federal regulations, processing timelines, change of ownership/officer updates, specialty changes, new enrollments, location additions, backdate requests, and documentation needs.
• Prepare and review group enrollment applications, DOO submissions, revalidations, and re-enrollments for government and commercial payers.
• Manage group enrollment activities to ensure accurate and timely enrollment of legal entities and service locations.

Documentation & Compliance

• Document all group-related information in the Provider Enrollment system and other applicable platforms.
• Ensure adherence to HIPAA, Code of Federal Regulations (CFR), and company policies.
• Maintain strict confidentiality of proprietary information.

Risk Mitigation & Communication

• Escalate issues or denials related to enrollment to mitigate risk.
• Notify the Provider Enrollment Manager and Team Lead upon enrollment approval to initiate downstream processes (e.g., claims release).
• Establish relationships with internal departments to address enrollment issues and share updates.

Growth & Special Projects

• Support organic growth and acquisitions by gathering necessary data and documents for enrollment.
• Assist with special projects and demonstrate flexibility in taking on additional responsibilities as needed.

Education/Experience:             

• High school diploma required. Associate or bachelor’s degree preferred.
• Equivalent combination of education and experience will be considered.             
• 3–5 years of experience in Provider Enrollment.
• Experience with group and individual enrollments across multiple states.

Knowledge/Skills:

• Strong knowledge of state and federal regulations, hospital standards, NCQA guidelines, and payer requirements (government and commercial).
• Strong organizational, time management, and communication skills.
• Strong critical thinking and analytical skills related to group applications and regulations.
• Strong understanding of corporate entity structures and enrollment methodologies.
• Ability to research and interpret applicable statutes and regulations.
• High attention to detail and accuracy.
• Assertiveness and ability to work independently.
• Proficiency in internet research and technology tools.

Software:

• Proficieny with PECOS (Medicare) required 

Benefits for Full Time employees and qualified dependents: 

• Medical, Prescription, Dental, Vision Insurance
• Progyny Fertility Benefits
• Livongo Diabetes Management
• Teladoc Health and Second Opinion Services
• Smart Shopper
• 401(K) Thrift Program & Sharing Plan**
• Employee Stock Purchase Plan (ESPP) – 15% discount*
• Basic Employee; Spouse; Child Life Insurance
• Accidental Death and Dismemberment (AD&D)
• Employee Optional Life and AD&D
• Short & Long Term Disability
• Pre-Tax Health Savings Accounts (HSA)
• Employee and Dependent Flexible Spending Account (FSA)
• Family Medical Leave Act (FMLA)**
• Parental Leave Benefit
• Sick Pay Bank
• Employee Assistance Program (EAP)**
• Group Aflac Policies
• Identity Theft Protection
• Employee Charitable Fund
• Care.com
• Various Discount Programs

*Part Time Regular employee classifications also receive this benefit

**Available to part-time regular and part-time casual employees aged 21 and over

Pediatrix Medical Group is one of the nation’s leading providers of highly specialized health care for women, babies and children. Since 1979, Pediatrix has grown from a single neonatology practice to a national, multispecialty medical group. Pediatrix-affiliated clinicians are committed to providing coordinated, compassionate and clinically excellent services to women, babies and children across the continuum of care, both in hospital settings and office-based practices. The group’s high-quality, evidence-based care is bolstered by significant investments in research, education, quality-improvement and safety initiatives. 

Please Note: Fraudulent job postings/job scams are becoming increasingly common. All genuine Pediatrix job postings can be found through the Pediatrix Careers site: www.pediatrix.com/careers.

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All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.