Provider Enrollment Specialist

Emory•Atlanta, GA

4d•Hybrid

About The Position

The Provider Enrollment Specialist coordinates the enrollment and onboarding of physicians and advanced practice providers into the Emory Healthcare Network (EHN), a clinically integrated network. This position serves as the primary liaison between providers, internal credentialing teams, and network administration to facilitate timely provider enrollment and onboarding. The Specialist maintains provider records, verifies compliance with EHN participation requirements, monitors credentialing and payer enrollment activities, and supports an efficient provider onboarding experience.

Requirements

High School Diploma or equivalent.
One (1) to three (3) years of experience in provider enrollment, credentialing, medical billing, or a related healthcare administrative function.
Knowledge of medical terminology, provider credentialing processes, payer contracting, provider reimbursement, and physician practice operations.
Knowledge of healthcare provider enrollment processes, including maintaining provider records and application documentation.
Proficiency with credentialing software, Microsoft Office applications (Excel and Word), and payer web portals.
Ability to accurately review, verify, and maintain provider enrollment and credentialing documentation.
Strong organizational skills with the ability to manage multiple priorities and meet established deadlines.
Strong analytical and problem-solving skills with exceptional attention to detail.
Excellent verbal and written communication skills with the ability to effectively collaborate with providers and internal stakeholders.
Ability to work independently and effectively in a fast-paced environment while maintaining a high degree of accuracy.

Nice To Haves

Associate's or Bachelor's degree in Healthcare Administration, Business Administration, or a related field.
Experience with Medicaid and Medicare provider enrollment processes.

Responsibilities

Coordinates provider onboarding, enrollment, and credentialing activities for physicians and advanced practice providers joining the Emory Healthcare Network.
Tracks provider enrollment applications and collaborates with providers to ensure all onboarding requirements are completed accurately and within established timeframes.
Monitors provider participation status and payer effective dates and communicates enrollment status updates to providers upon completion.
Validates provider compliance with Emory Healthcare Network participation criteria and strategic alignment requirements.
Verifies the completeness and accuracy of provider enrollment applications and supporting documentation.
Supports compliance with applicable enrollment, credentialing, and participation requirements throughout the onboarding process.
Maintains accurate provider demographic, credentialing, and participation information within enrollment systems.
Updates and monitors provider records to ensure accurate and current information is maintained throughout the enrollment process.
Serves as the primary liaison between providers and internal departments throughout the enrollment and credentialing process.
Facilitates a seamless transition from the Emory Healthcare Network onboarding process to the Emory credentialing process.
Responds to provider inquiries and provides guidance regarding enrollment requirements and application status.
Performs other duties as assigned.