Provider Enrollment Specialist

Job Summary

A company is looking for a Provider Enrollment Specialist responsible for managing the payer enrollment process for independent providers.

Key Responsibilities

• Enrolls providers with commercial health plans, Medicaid, and Medicare
• Maintains and reviews data in CredentialStream for accuracy and follows up with health plans post-submission
• Collaborates with the credentialing team and attends relevant internal meetings

Required Qualifications

• 2+ years of experience in payer enrollment function
• Experience with Medicare/Medicaid payer systems is required
• Familiarity with credentialing software, preferably Verity CredentialStream
• Experience in RCM - Enrollment claim resolution preferred
• Must comply with HIPAA rules and regulations