Provider Enrollment Director

Job Summary

To enhance productivity and manage provider enrollment projects, the full-time remote Provider Enrollment Director will develop workflows, oversee departmental operations, and ensure compliance with insurance regulations while collaborating with clinical departments and payers.

Key responsibilities

• Develop and implement policies and procedures for provider enrollment activities, ensuring alignment with access to care and reimbursement
• Monitor and report on enrollment timelines, productivity, and compliance with Medicare, Medicaid, and commercial payer regulations
• Facilitate relationships with insurers and internal stakeholders to improve enrollment accuracy and efficiency

Required qualifications

• Bachelor's degree in healthcare or a business-related field; Master's degree preferred
• Seven years of progressive responsibility in provider enrollment, with five years in a supervisory or managerial role
• Expertise in Medicare, Medicaid, and commercial payer regulations
• Knowledge of EPIC PB Resolute and HIPAA compliance
• Strong understanding of clinical practice management and medical billing processes