Provider Enrollment Specialist
Tasks
- Assist with payer delegation audits
- Communicate enrollment status updates to providers
- Coordinate provider enrollment
- Ensure compliance with federal and state regulations
- Ensure compliance with payer requirements
- Generate enrollment status reports
- Maintain provider records in credentialing systems
- Maintain provider roster and demographics
- Manage provider revalidation
- Monitor payer application status
- Report key performance metrics
- Resolve payer enrollment issues
- Support commercial payer enrollment issues
- Track aging applications
- Update provider records in CAQH
- Update provider records in enrollment databases
- Update provider records in payer portals
- Verify provider data consistency across systems
Perks/Benefits
- 401k match
- Company holidays
- Dental insurance
- Employee assistance program
- Financial assistance
- Hybrid work schedule
- Legal assistance
- Medical insurance
- Paid time off
- Parental leave
- Pet insurance
- Vision insurance
- Wellness benefits
Skills/Tech-stack
Behavioral health | Behavioral health licensing | CAQH | Managed care | Medicaid | Medicaid Enrollment | Medicare | Medicare and Medicaid enrollment | Payer portal | Provider Revalidation | Provider credentialing | Provider enrollment | Roster management
Education
Associate Degree | Bachelor of Science | High School Diploma
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