Senior Provider Enrollment Specialist

Job Summary

Seeking a motivated Senior Provider Enrollment Specialist, this full-time remote position will oversee complex enrollment processes, ensure compliance with accreditation standards, and provide mentorship to junior staff while enhancing credentialing workflows.

Key responsibilities

• Lead the submission and oversight of complex initial applications, reappointments, and recredentialing efforts
• Conduct quality assurance reviews of credentialing documents and workflows to ensure compliance and accuracy
• Provide mentorship and training to Payer Enrollment Specialists and collaborate with internal stakeholders

Required qualifications

• Associate's degree required; Bachelor's degree in healthcare administration or a related field preferred
• 3-5 years of experience in payer enrollment or healthcare credentialing, including familiarity with NCQA, URAC, and CMS standards
• Certification as a Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medical Services Management (CPMSM) is strongly preferred
• Advanced understanding of credentialing workflows and regulatory compliance
• Proficient in credentialing and enrollment systems, with strong Excel and Microsoft Office Suite skills