Provider Enrollment
About The Position
Prepare and submit enrollment and re-enrollment applications for healthcare providers to Medicare, Medicaid, and commercial insurance plans. Maintain accurate and up-to-date provider records in internal databases and payer portals. Track application statuses and follow up with payers to ensure timely processing. Collaborate with providers and credentialing staff teams to gather required documentation and resolve discrepancies. Monitor and manage re-credentialing and revalidation timelines to ensure continuous participation. Respond to inquiries from providers and internal departments regarding enrollment status and requirements. Assist with audits and reporting related to provider enrollment activities.
Requirements
- High school diploma or equivalent required
- 1–2 years of experience in provider enrollment, credentialing, or healthcare administration.
- Strong understanding of Medicare, Medicaid, and commercial insurance enrollment processes.
- Excellent organizational, communication, and problem-solving skills.
- Ability to manage multiple tasks and meet deadlines in a fast-paced environment.
Nice To Haves
- associate or bachelor’s degree in healthcare administration or related field preferred
- Familiarity with CAQH
Responsibilities
- Prepare and submit enrollment and re-enrollment applications for healthcare providers to Medicare, Medicaid, and commercial insurance plans.
- Maintain accurate and up-to-date provider records in internal databases and payer portals.
- Track application statuses and follow up with payers to ensure timely processing.
- Collaborate with providers and credentialing staff teams to gather required documentation and resolve discrepancies.
- Monitor and manage re-credentialing and revalidation timelines to ensure continuous participation.
- Respond to inquiries from providers and internal departments regarding enrollment status and requirements.
- Assist with audits and reporting related to provider enrollment activities.
Benefits
- Medical, dental & vision
- Critical Illness, Accident, and Hospital
- 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
- Life Insurance (Voluntary Life & AD&D for the employee and dependents)
- Short and long-term disability
- Health Spending Account (HSA)
- Transportation benefits
- Employee Assistance Program
- Time Off/Leave (PTO, Vacation or Sick Leave)
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Career Level
Senior
Education Level
High school or GED
