Provider Enrollment Specialist

Role Overview

• Manage provider and facility enrollment with health plans and payors, ensuring compliance with contractual, regulatory, and accrediting requirements
• Collaborate with credentialing, recruitment, and sales teams to support a consistent and accurate weekly enrollment process
• Prepare and submit provider enrollment reports, respond to payer inquiries and validations, and proactively resolve discrepancies
• Maintain accurate enrollment records to ensure precise reporting for providers, clients, and credentialed therapists
• Review and maintain provider enrollment data and directories, ensuring policies, workflows, and reporting timelines are met
• Support resolution of enrollment‑related contract and claims issues with payors and providers
• Create clear, engaging training materials and support dissemination of enrollment information as needed
• Conduct periodic file reviews to evaluate accuracy, timeliness, and data quality, identifying opportunities to improve performance and efficiency
• Identify and recommend process improvements and automation opportunities to increase accuracy and scalability
• Adhere to HIPAA guidelines and all applicable privacy and security regulations
• Other projects and duties as assigned.

Requirements

• High school diploma or GED.
• Experience working in provider enrollment or a closely related healthcare operations function.
• Strong attention to detail with a focus on accuracy and compliance.
• Excellent customer service, written, verbal, and presentation skills.
• Highly organized with the ability to manage multiple priorities and deadlines.
• Comfortable navigating multiple software systems and screens simultaneously.
• Proficient with virtual collaboration tools such as Microsoft Teams or Zoom.

Benefits

• 100% employer paid medical health insurance premium option available
• Dental and Vision insurance
• 401(k) with company match
• Generous PTO and paid holidays
• Supportive team and leadership invested in your success