Provider Enrollment Specialist

Job Summary

Supporting the enrollment process, the remote Provider Enrollment Specialist will review, research, analyze, and process provider applications to ensure file accuracy and compliance with established standards.

Key Responsibilities

• Review and validate medical provider enrollment applications, including initial, re-enrollment, reactivation, or updates
• Verify provider data through internal databases and external agencies, and set up EFT accounts
• Communicate with providers and internal departments to resolve discrepancies and supply application materials to potential enrollees

Required Qualifications

• Experience managing CMS 855 applications and utilizing PECOS
• Prior customer service representative experience
• Previous provider enrollment experience for Medicare
• High school diploma or equivalent required; Associate's or Bachelor's degree preferred
• Proficiency in Microsoft Office