Provider Enrollment Specialist

Job Summary

A company is looking for a Provider Enrollment Specialist.

Key Responsibilities

• Coordinate the enrollment and re-credentialing process for providers with third-party payers
• Maintain accurate data in internal systems and ensure alignment between enrollment, credentialing, and billing records
• Collaborate with billing staff to resolve claim denials and manage compliance with provider enrollment requirements

Required Qualifications

• Minimum 2 years of experience in Revenue Cycle, Provider Enrollment, Credentialing, or Billing
• Bachelor's degree in business, healthcare administration, or a related field is preferred
• Familiarity with systems such as CAQH, PECOS, CHAMPS, and Availity
• Knowledge of delegated credentialing processes and CMS enrollment regulations
• Healthcare facility and professional billing experience is a plus