Provider Enrollment Manager

ABOUT CIRCLE MEDICAL

Circle Medical is the fastest-growing telemedicine provider in the US and has seen incredible growth of over 100% per year over the past three years.

Circle Medical is a venture-backed Y-Combinator healthcare startup on a mission to bring quality, delightful primary care to everyone on the planet. Built by top-tier physicians, engineers, and designers, our medical practice and underlying technology have pioneered how people find and receive care.

More about us can be found on our website.

DESCRIPTION

The Provider Enrollment Manager Specialist oversees the provider enrollment process for Circle’s providers, ensuring timely and accurate enrollment with government and commercial payers and IPAs. This position plays a critical role in the revenue cycle by combining hands on enrollment expertise with leadership responsibilities, guiding a team of enrollment specialists to meet departmental goals, maintain compliance and optimize the reimbursement process. The team lead serves as a liaison between providers, payers and internal departments resolving complex issues and driving operational efficiency.

WHAT YOU'LL DO

Team Leadership and Supervision

- Supervise, mentor and train a team of provider enrollment specialists, fostering a collaborative and high performing work environment.

- Manage a team of specialists to ensure Complete and submit credentialing applications, re-credentialing forms, and maintenance updates as required by payers.

- Assign tasks monitor team performance and ensure adherence to deadlines and quality standards.

Provider Enrollment Management

- Oversee the end-to-end provider enrollment process, including initial applications, re-enrollment, revalidation and updates for providers.

- Ensure accurate and timely submission of enrollment applications to payers, maintaining compliance with federal, state and payer specific regulations.

- Track and monitor application statuses, following up with payers and providers to resolve deficiencies or delays.

Compliance & Quality Assurance

- Ensure all processes and documentation comply with federal, state, and payer regulations.

- Conduct internal audits of provider files and respond to audit requests from payers or regulators.

- Assist in policy development and process improvements related to enrollment and credentialing.

Process Improvement and Reporting

- Acts as a primary point of contact for escalated enrollment issues, collaborating with payers/IPAs, providers and internal departments (RCM, payer contract management, credentialing).

- Provide guidance and support to providers and administrative staff on credentialing best practices.

QUALIFICATIONS

Education & Experience

- Associate’s or Bachelor’s degree in healthcare administration, business, or related field preferred.

- Minimum 5 years of experience in provider enrollment, credentialing, or healthcare administration.

- Familiarity with payer-specific requirements, CAQH, NPPES, PECOS, and credentialing software.

- Minimum of 1 year of people leadership/management experience.

Skills & Competencies

- Strong organizational and time management skills.

- Attention to detail and accuracy in data entry and documentation.

- Excellent written and verbal communication skills.

- Proficient in Microsoft Office and enrollment portals.

- Ability to work independently and as part of a collaborative team.

- Detail oriented with string problem solving and analytical capabilities.

Preferred Qualifications

- CPCS or CPMSM certification through NAMSS is a plus.

- Experience with large group practices or multi-specialty providers.

- Working knowledge of state and federal healthcare regulations.

Work Environment

- May involve occasional travel for site visits or payer meetings.

COMPENSATION

Circle Medical offers a competitive salary and benefits package, as well as opportunities for professional growth and development. In alignment with our values, Circle Medical has transparent salaries based on merit-based output levels, and our total rewards include equity options.

This is a full-time, salaried exempt position with an annual salary range of $70,000-90,000 (USD) dependent on location, plus generous vacation, full health benefits, and 401K with company matching.

Additional Benefits:

- Flexible vacation, eligibility after 90-days 

- 10 annual paid Holidays

- $500 annual education and development reimbursement 

- Medical, Dental, Vision benefits, Life & additional supplemental coverage options

- 401K + Company Matching Program

Circle Medical is an equal-opportunity employer and affirmatively seeks diversity in its workforce. Circle Medical recruits qualified applicants and advances in the employment of its employees without regard to race, color, religion, gender, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, ethnic or national origin, marital status, veteran status, or any other status protected by law.