Provider Enrollment Specialist

National Partners In Healthcare•Richardson, TX

3d•Remote

About The Position

National Partners in Healthcare (NPH), a healthcare company specializing in anesthesiology, is hiring a remote Provider Enrollment Specialist. The role requires residence in Arizona, Texas, Tennessee, New Hampshire, Florida, or North Carolina. The Specialist manages provider enrollment and revalidation with government and commercial payers, ensuring applications and provider records are accurate, timely, and compliant with payer, regulatory, and organizational requirements. The position serves as a liaison among providers, payers, and internal departments to resolve enrollment issues, help prevent claim delays, and support uninterrupted reimbursement. This position has daily, ongoing contact with administrative staff, clinical providers, and outside contacts, and has no direct reports. NPH describes its workplace values as accountability, collaboration, continuous improvement, teamwork, customer service, and integrity. Full-time positions are eligible for a discretionary bonus and comprehensive benefits package. Salary ranges are not provided in the posting.

Requirements

Associate’s degree in Business Administration or a related field, or an equivalent combination of education and experience.
At least two years of credentialing experience.
Two or more years of experience in payer credentialing.
A minimum of two to five years of experience and demonstrated proficiency in provider enrollment payer credentialing.
Excellent computer, data-entry, and clerical skills, including knowledge of business office procedures.
Excellent interpersonal, telephone, and communication skills.
Ability to multitask and handle varied situations requiring judgment and poise.
Strong attention to detail and organizational abilities.

Nice To Haves

Working knowledge of the healthcare and credentialing industry, including medical-legal issues and laws, regulatory agencies, and national standards.

Responsibilities

Prepare, submit, and track provider enrollment, revalidation, and recredentialing applications with government and commercial payers, including Medicare, Medicaid, and commercial insurance plans.
Maintain current and accurate provider demographic, licensure, certification, and contract information in enrollment systems, credentialing databases, and payer portals.
Serve as the primary point of contact for providers regarding enrollment status, documentation requirements, timelines, and payer correspondence.
Review enrollment applications for completeness, accuracy, and compliance with payer and regulatory requirements before submission.
Communicate with payer representatives to resolve application discrepancies, follow up on pending submissions, and address denials or terminations.
Coordinate with credentialing, billing, compliance, and contracting departments to align provider data and minimize claim rejections.
Monitor enrollment status and proactively identify and resolve issues that could delay provider activation or disrupt reimbursement.
Document enrollment activities, correspondence, and approvals in accordance with organizational policies and audit standards.
Ensure timely revalidation and recredentialing to prevent lapses in payer participation.
Stay current on payer enrollment guidelines, CMS regulations, and industry best practices.
Perform other duties as assigned.