Provider Enrollment Specialist
New
Remote work arrangement within the United States., Monday–Friday, 8:00 AM–5:00 PMFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- Minimum of 2 years of experience in healthcare-related environments.
- Required Skills
- Microsoft OfficeData management
Requirements
- High school diploma or equivalent required.
- Minimum of 2 years of experience in healthcare-related environments.
- Strong understanding of healthcare payer systems, credentialing processes, and regulatory requirements.
- Proficiency in Microsoft Office tools, including Word, Excel, Access, and Outlook.
- Strong analytical, problem-solving, and organizational skills with high attention to detail.
- Ability to manage multiple priorities in a fast-paced, deadline-driven environment.
- Strong communication skills with the ability to interact effectively with providers, administrators, and payer representatives.
- Ability to work independently while maintaining strong collaboration with cross-functional teams.
- Strong interpersonal skills with a service-oriented and solutions-focused mindset.
Responsibilities
- Support the full provider enrollment, credentialing, and recredentialing lifecycle across managed care, Medicare, Medicaid, and governmental payer programs.
- Serve as a concierge-style point of contact, guiding providers through onboarding, enrollment, and revalidation processes.
- Maintain and update enrollment databases, ensuring accurate tracking of provider status, effective dates, and payer participation.
- Monitor documentation, licenses, and certifications to ensure compliance and active provider status across all markets.
- Track enrollment packet completion and proactively escalate issues to hiring managers or recruiters when delays occur.
- Develop and maintain reporting tools to communicate enrollment status, timelines, and revenue impact to leadership and billing teams.
- Coordinate with administrators and operational leaders to support new service lines, facilities, and provider onboarding under existing contracts.
- Analyze enrollment and credentialing issues, troubleshoot discrepancies, and recommend or escalate corrective actions.
- Act as a knowledge resource for internal teams and external stakeholders regarding enrollment policies and processes.
- Maintain strict confidentiality while ensuring compliance with regulatory and accreditation standards.
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