Provider Enrollment Specialist (Remote)

Blue Cloud • Phoenix, AZ

3d • Remote

About The Position

Blue Cloud is a pediatric Ambulatory Surgery Center company focused on dental restorative and exodontia surgery for pediatric and special needs patients under general anesthesia. The company is mission-driven and committed to safe, high-quality, accessible care while reducing costs for families and payers.

The Provider Enrollment Specialist manages provider and entity enrollments, recredentialing, and payer enrollment activities with Medicare, Medicaid, and commercial insurance plans. The role supports timely, accurate enrollments, maintains provider records, resolves payer-related issues, and helps ensure uninterrupted billing and reimbursement operations. The specialist independently manages a high-volume workload across multiple states while coordinating with internal teams and payer representatives.

This is a full-time remote position, Monday through Friday, with a start time between 7:00 AM and 9:00 AM. No weekends, holidays, on-call work, or travel are required. Applicants must reside in AZ, CO, FL, ID, MD, MO, PA, SC, TN, or TX; California residents are not eligible.

Requirements

• At least 3 years of payer enrollment experience in a healthcare setting.
• Experience enrolling both individual providers and healthcare entities.
• Strong understanding of payer enrollment requirements, credentialing processes, and provider lifecycle management.
• Experience with multi-state Medicaid enrollments.
• Hands-on experience using CAQH, Availity, and PECOS.
• Strong knowledge of EFT enrollment processes and payer requirements.
• Ability to work independently and drive enrollments from application through approval.
• Excellent organizational skills and exceptional attention to detail.
• Strong problem-solving and critical-thinking abilities.
• Excellent verbal and written communication skills.
• Proficiency in Microsoft Office Suite, including Word and Excel.
• Ability to maintain confidentiality and appropriately handle sensitive information.
• Applicants must reside in AZ, CO, FL, ID, MD, MO, PA, SC, TN, or TX; California residents are not eligible.

Nice To Haves

• Experience managing multi-state provider and entity enrollments across a large geographic footprint.
• Experience working with multiple commercial, Medicare, and Medicaid payers.
• Experience with credentialing software and provider enrollment databases.
• Experience in an ambulatory surgery center (ASC) or healthcare services environment.

Responsibilities

• Facilitate initial enrollments, recredentialing, and payer enrollment applications for providers and entities with Medicare, Medicaid, and commercial insurance plans.
• Prepare, review, and submit enrollment applications for accuracy, completeness, and timely submission.
• Monitor application status and proactively follow up with payers to resolve issues and expedite approvals.
• Establish and maintain relationships with payer representatives.
• Document payer communications and enrollment updates in the credentialing system.
• Maintain accurate provider and entity records, credentialing information, and enrollment data.
• Track enrollment, credentialing, and recredentialing deadlines to prevent interruptions in payer participation or reimbursement.
• Complete and submit EFT agreements and related payer documentation.
• Maintain and update provider information in payer directories and databases.
• Manage and maintain provider CAQH profiles, keeping information current and accurate.
• Collaborate with Revenue Cycle, Billing, Credentialing, Operations, and other internal stakeholders on enrollment-related issues and questions.
• Provide enrollment status updates, reporting, and turnaround-time metrics to leadership.
• Independently prioritize and manage multiple enrollments simultaneously.
• Research, troubleshoot, and resolve enrollment barriers with minimal supervision.
• Manage multi-state provider and entity enrollments, including Medicaid enrollments across multiple states.

Benefits

• Remote work opportunity.
• Competitive benefits package including medical, disability, and voluntary benefit plans.
• Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA).
• 401(k) with company match.
• Paid Time Off (PTO).
• Opportunity to work with a passionate, dedicated, and growing team focused on improving access to care.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed