Medicaid Enrollment Specialist

Job Summary

A company is looking for a MSS/ Payer Enrollment Specialist to support its provider network and ensure compliance in credentialing processes.

Key Responsibilities

• Compile and submit payer enrollment applications for Medicaid, Medicare, and Commercial payors, ensuring timely processing
• Maintain provider credentialing portfolio, ensuring compliance with NCQA, CMS, HIPAA, and relevant regulations
• Guide newly onboarded providers through requirements and manage documentation and data entry into the provider platform

Required Qualifications

• High School Diploma or GED
• A minimum of 2 years of credentialing experience, specifically in Medicaid enrollment
• Understanding of the impact of provider credentialing on the revenue cycle
• Exceptional organizational skills
• Familiarity with NCQA guidelines is preferred