Provider Enrollment Specialist

Job Summary

A company is looking for a Provider Enrollment Specialist.

Key Responsibilities

• Coordinate and manage provider enrollment and re-credentialing processes with third-party payers
• Maintain accurate enrollment data in internal systems and ensure compliance with relevant regulations
• Collaborate with billing staff to resolve claim denials related to enrollment issues

Required Qualifications

• Minimum 2 years of experience in Revenue Cycle, Provider Enrollment, Credentialing, or Billing
• Bachelor's degree in business, healthcare administration, or related field is preferred
• Familiarity with credentialing systems such as CAQH, PECOS, and others
• Knowledge of delegated credentialing processes and CMS enrollment regulations
• Experience with claims reimbursement processes