Provider Enrollment Specialist

Job Summary

Overseeing the provider enrollment lifecycle, the full-time Sr. Provider Enrollment Specialist will manage credentialing processes with various payers, ensure compliance with regulations, and resolve complex enrollment issues while working remotely.

Key responsibilities

• Manage and execute provider enrollment and recredentialing processes with commercial, Medicare, and Medicaid payers
• Act as a liaison to resolve enrollment issues and collaborate with internal teams to improve enrollment timelines
• Maintain compliance with federal, state, and payer-specific guidelines related to provider enrollment

Required qualifications

• Associate's degree in Healthcare Administration, Business, or related field required (Bachelor's preferred)
• Minimum of 3-5 years of experience in provider enrollment, credentialing, or revenue cycle operations
• Strong understanding of payer enrollment processes for commercial, Medicare, and Medicaid plans
• Experience with provider enrollment portals and electronic credentialing systems
• Proficiency in Microsoft Office Suite and experience with healthcare information systems