Provider Enrollment Specialist - Remote Work Available to MN, ND or SD Applicants! (72547)
About The Position
The Provider Enrollment Specialist is responsible for managing and coordinating the enrollment, credentialing, and revalidation of healthcare providers with government and commercial payers. This role ensures providers are accurately enrolled, maintained, and compliant with payer, regulatory, and organizational requirements to support timely reimbursement and uninterrupted patient care. In addition, the Specialist supports denial resolution efforts related to enrollment and credentialing issues, working collaboratively with billing, revenue cycle, and payer representatives to identify root causes and implement corrective actions. The Provider Enrollment Specialist serves as a key liaison between providers, payers, and internal departments, maintains accurate and up-to-date enrollment records, monitors participation status, and performs other related duties as assigned to support operational and financial goals.
Requirements
- Requirements are representative of minimum levels of knowledge, skills, and/or abilities.
- Associate's degree in a related field preferred.
- Successful completion of the pre-employment health screening process is required.
- Must be able to attend the work site as scheduled. Remote opportunities available for candidates in Minnesota, North Dakota or South Dakota only.
- Ability to communicate effectively, in English, both orally and in writing.
Nice To Haves
- Previous experience in provider enrollment preferred.
- Medical Coding and/or billing experience preferred.
Responsibilities
- Initial Enrollment of all providers with all health plans.
- Re-enrollment of all providers with all health plans.
- Termination of providers with health plans.
- Facility recredentialing with health plans.
- Facility disclosure of ownership updates and renewals.
- Annual provider compliance with health plans.
- Management and maintenance of provider rosters.
- Assist with patient estimates.
- Monitor and manage insurance payment variances.
- Management of denials related to provider enrollment, including appeals.
- Other duties as assigned.
Benefits
- Lake Region Healthcare is pleased to offer a comprehensive benefit program designed to meet your unique needs. This includes medical and dental coverage; HSA, FSA and 401k plans; EAP, life and disability coverage; voluntary accident, critical illness and hospital indemnity coverage; pet insurance, ID theft protection and legal services. For new employees, the effective date of coverage for most plans is the first of the month, following a 30-day waiting period.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
Number of Employees
501-1,000 employees
