Senior Enrollment Representative

UnitedHealth Group•Eden Prairie, MN

20h•$20 - $36•Remote

About The Position

This role is ideal for someone who thrives in a fast-paced, evolving environment and brings both deep technical expertise and a strong sense of ownership. You’ll be expected to navigate complex payer requirements, manage high-volume workloads, and collaborate closely with Revenue Cycle Management (RCM) to ensure enrollment accuracy directly supports timely reimbursement. Get ready for some significant challenge. This is a performance driven, fast paced environment where accuracy is key. You’ll be working with complex requirements across payers, ensuring compliance with NCQA, CMS, and state regulations while directly impacting provider experience and organizational revenue. Positions in this function are responsible for all activities associated with credentialing and provider enrollment. This includes processing provider applications and re-applications, managing roster submissions, maintaining data integrity across systems, and ensuring high-quality standards are upheld. This role also includes auditing work, improving processes, and supporting compliance with regulatory requirements.

Requirements

Extensive work experience, often across multiple functions (Enrollment, Credentialing, RCM)
Work frequently requires navigating ambiguity and developing new or improved procedures
Works independently with a high degree of accountability
Mentors others and acts as a subject matter expert
Coordinates activities across teams and functions
Drives process improvements and operational efficiency
High School Diploma/GED
4+ years of healthcare provider enrollment experience
2+ years of experience working with compliance workflows and processes, including NCQA policies and practices
2+ years of experience researching and applying payer and government regulatory requirements
Intermediate level of proficiency with MS Excel and Word

Nice To Haves

Demonstrated experience managing payer rosters and complex enrollment workflows
Experience working with MD-Staff (or similar credentialing/enrollment systems)

Responsibilities

Manage end-to-end provider enrollment workflows, including roster submissions, individual enrollments, and revalidations across multiple payers
Maintain and update provider data across systems including MD-Staff, roster templates, and payer platforms, ensuring consistency and accuracy
Proactively track and follow up on enrollment statuses, resolving delays and preventing gaps that impact billing or network participation
Serve as a subject matter expert on payer-specific requirements, identifying nuances and adapting processes accordingly
Partner closely with RCM to investigate and resolve claim denials, reimbursement delays, and enrollment-related billing issues
Conduct audits, identify root causes of errors, and support process improvements to enhance accuracy and efficiency
Manage high-volume workloads and competing priorities, ensuring deadlines are consistently met without sacrificing quality
Operate effectively in an evolving environment where processes and job aids change; demonstrate the ability to bring structure and clarity
Act as a go-to resource for complex work while supporting overall team performance and success
Take ownership of issues from identification through resolution, including cross-functional coordination when needed
Support process improvement efforts by contributing to projects and helping refine existing workflows and team processes