Sr. Provider Enrollment Specialist
New
The base salary range for this full-time position is $60,500 – $79,200 per year in the United States. This posted range reflects the portion of our internal salary band that is currently funded for new hires in this role across our standard labor markets (Zones A–C). At this time, we are not budgeting for hires in higher-cost Zone D markets (e.g., San Francisco Bay Area CA, New York City NY, San Jose CA) for this role.Full-TimeSenior
Salary60,500 - 79,200 USD per year
Apply NowOpens the employer's application page
Job Details
- Experience
- 3-5 years
- Required Skills
- Microsoft OfficeEHR
Requirements
- Associate’s degree in Healthcare Administration, Business, or related field (Bachelor’s preferred).
- Minimum of 3-5 years of experience in provider enrollment, credentialing, or revenue cycle operations.
- Strong understanding of payer enrollment processes for commercial, Medicare, and Medicaid plans.
- Experience working with provider enrollment portals (e.g., PECOS, CAQH, Availity).
- Experience with electronic credentialing systems.
- Ability to analyze enrollment data and resolve complex payer or application issues effectively.
- Proficiency in Microsoft Office Suite.
- Experience with healthcare information systems (EHR, practice management systems).
- Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) preferred.
- Experience in a multi-specialty medical group or health system preferred.
Responsibilities
- Manage and execute provider enrollment and recredentialing processes with commercial, Medicare, and Medicaid payers.
- Ensure accurate and timely submission of enrollment applications and supporting documentation.
- Monitor enrollment timelines, proactively following up with payers to avoid delays in reimbursement.
- Maintain current knowledge of payer enrollment requirements, regulations, and industry standards.
- Accurately enter and maintain provider demographic and credentialing information in internal databases and payer portals.
- Audit provider files and systems regularly to ensure accuracy and compliance.
- Track and manage license renewals, CAQH attestation, NPI registrations, and other provider data elements.
- Act as a liaison between payers, providers, and internal stakeholders to resolve enrollment issues, rejections, and lapses.
- Collaborate with billing and denial management teams to resolve enrollment-related claim denials.
- Provide subject matter expertise and mentorship to junior team members regarding enrollment best practices.
View Full Description & ApplyYou'll be redirected to the employer's site
