Provider Enrollment Specialist

Job Summary

To support the timely and accurate economic credentialing and provider enrollment processes, the full-time Provider Enrollment Specialist will manage a complex payer credentialing environment, ensuring compliance with regulations while collaborating with healthcare providers and administrators in a remote setting.

Key responsibilities

• Guide providers through the economic credentialing/enrollment and recredentialing/revalidation process in collaboration with hiring and onboarding personnel
• Develop and maintain a credentialing/enrollment database to ensure active status among managed care payers and governmental plans
• Track registration packets and communicate status updates to relevant stakeholders to manage start dates and prevent revenue loss

Required qualifications

• High School Diploma or equivalent
• Two years of health care industry experience
• Basic understanding of managed care contracting and credentialing processes
• Intermediate skill level in Microsoft Word, Excel, Access, and Outlook
• Experience in professional billing or credentialing preferred