About the job
About Us
Chatterboxes is a pediatric Speech-Language Pathology practice that is clinician-owned and built around a sanctuary model, which aims to support both children and the clinicians dedicated to their care. As we expand our reach into Northern Virginia, we are forming partnerships in Early Intervention, including the Alexandria PIE Program, and are in need of specialized expertise to navigate the complexities of Medicaid Managed Care enrollment.
Purpose of This Role
We are looking for a part-time, remote Enrollment Specialist to join us as a contractor. This role is critical to successfully enrolling with Virginia Medicaid Managed Care Organizations (MCOs) and establishing a clean, scalable billing foundation. The enrollment process can be intricate and time-consuming; therefore, we seek someone with prior experience who can efficiently guide us through this process.
Responsibilities
- Oversee enrollment processes with Virginia Medicaid MCOs (e.g., Anthem, Aetna, United, etc.)
- Interpret and complete MCO-specific requirements and applications
- Coordinate both organizational and provider credentialing (group and individual NPIs)
- Ensure compliance with:
- Early Intervention billing requirements (IFSP-based services)
- MCO billing processes and reimbursement structures
- Advise on workflows for:
- Direct billing to MCOs (vendor model versus state billing)
- Pathways for uninsured patients and their coverage through MCOs
- Support the establishment of:
- Background check compliance (utilizing online systems)
- Fidelity assessments and necessary documentation
- Act as a liaison between Chatterboxes and MCO representatives
- Provide clear timelines, checkpoints, and expectations (as this process can be slow, visibility is essential)
Qualifications
Required Experience
- Demonstrated experience enrolling providers or organizations with Virginia Medicaid MCOs
- Comprehensive understanding of:
- Early Intervention services (IFSP model)
- Medicaid billing structures in Virginia
- Prior experience with PECOS, NPPES, and/or Medicaid portals is preferred
- Ability to navigate ambiguity and proactively advance processes
- Bonus: Experience collaborating with therapy providers (SLP, OT, PT)
Success Indicators
- Chatterboxes is fully enrolled with targeted Virginia MCOs
- Billing workflows are well-defined and operational
- A repeatable system for onboarding future clinicians is established
- Leadership has clarity (not confusion) regarding requirements, timelines, and next steps
Additional Context
- In Alexandria’s Early Intervention model, vendors bill MCOs directly rather than the state
- If a family incurs no cost share, the Alexandria PIE Program will cover the remaining balance
- We foresee ongoing collaboration through quarterly vendor meetings