Provider Enrollment Specialist - Preferred Therapy Providers
About The Position
Upstream Rehabilitation is looking for a Provider Enrollment Specialist to join our Preferred Therapy Providers Team! Upstream Rehabilitation is the country’s largest dedicated provider of outpatient physical and occupational therapy services. Our mission is to inspire and empower the lives we touch, to serve our communities, and to lead with purpose-driven passion. We are committed to delivering remarkable experiences and fostering an inclusive workplace where differences are valued and celebrated. With 1,200+ locations nationwide, 26 brand partners, and 8,000+ employees, Upstream operates at scale while leveraging data, technology, and innovation to drive smarter decisions and operational excellence across the organization. Reporting to the Director of Payor & Provider Operations, the Provider Enrollment Specialist plays a critical role in ensuring healthcare providers and facilities are accurately enrolled and maintained with health plans and payors. This position partners closely with credentialing, recruitment, sales and external payors to ensure compliance, accuracy and timely participation across contracted plans. You will be responsible for managing enrollment activities from end-to-end while helping improve processes that support growth, quality and operational excellence.
Requirements
- High school diploma or GED.
- Experience working in provider enrollment or a closely related healthcare operations function.
- Strong attention to detail with a focus on accuracy and compliance.
- Excellent customer service, written, verbal, and presentation skills.
- Highly organized with the ability to manage multiple priorities and deadlines.
- Comfortable navigating multiple software systems and screens simultaneously.
- Proficient with virtual collaboration tools such as Microsoft Teams or Zoom.
Nice To Haves
- Bachelor’s degree.
- Broader healthcare operations experience, such as credentialing, payor relations or claims support.
Responsibilities
- Manage provider and facility enrollment with health plans and payors, ensuring compliance with contractual, regulatory, and accrediting requirements
- Collaborate with credentialing, recruitment, and sales teams to support a consistent and accurate weekly enrollment process
- Prepare and submit provider enrollment reports, respond to payer inquiries and validations, and proactively resolve discrepancies
- Maintain accurate enrollment records to ensure precise reporting for providers, clients, and credentialed therapists
- Review and maintain provider enrollment data and directories, ensuring policies, workflows, and reporting timelines are met
- Support resolution of enrollment‑related contract and claims issues with payors and providers
- Create clear, engaging training materials and support dissemination of enrollment information as needed
- Conduct periodic file reviews to evaluate accuracy, timeliness, and data quality, identifying opportunities to improve performance and efficiency
- Identify and recommend process improvements and automation opportunities to increase accuracy and scalability
- Adhere to HIPAA guidelines and all applicable privacy and security regulations
- Other projects and duties as assigned.
Benefits
- 100% employer paid medical health insurance premium option available
- Dental and Vision insurance
- 401(k) with company match
- Generous PTO and paid holidays
- Supportive team and leadership invested in your success
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
1-10 employees
