Provider Enrollment Specialist
Tasks
- Assist with audits and compliance requests
- Coordinate onboarding documents and discrepancies
- Document actions in tracking tools
- Enroll providers and facilities
- Ensure compliance with CMS and state requirements
- Handle PHI and PII securely
- Maintain provider data in enrollment and claims systems
- Meet productivity and turnaround time standards
- Perform quality checks to prevent claim denials
- Recommend process improvements
- Research and resolve enrollment data issues
- Respond to provider inquiries about enrollment status
- Submit and track enrollment requests
- Update and terminate provider records
- Validate enrollment submission data
Perks/Benefits
- 401k plan
- Collaborative work culture
- Employee assistance program
- Medical/Dental/Vision insurance
- Paid Holidays
- Paid sick time
- Paid vacation
- Professional development opportunities
- Remote work schedule
Skills/Tech-stack
CMS provider directory | Credentialing | Data Management | HubSpot | Medicaid | Medicare | Microsoft Excel | Microsoft Outlook | Microsoft Word | Modio | NCQA | NPI | PII | Phi | Portals | Provider data | Provider data management | Provider enrollment | TIN | Taxonomy | Ticketing systems
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