Provider Enrollment Specialist

Job Summary

A company is looking for a Provider / Payor Enrollment Specialist.

Key Responsibilities

• Enrolls providers in commercial and government payor plans, ensuring timely completion of applications
• Monitors provider compliance with enrollment requests and manages documentation for accuracy
• Tracks and audits provider enrollment processes, reporting findings and issues to management

Required Qualifications

• High School Diploma or GED required
• 3 to 5 years of experience in a Provider Enrollment environment or healthcare setting
• Knowledge of Medicaid, Medicare, and commercial payor enrollment processes
• Experience with credentialing providers following NCQA standards preferred
• Bachelor's Degree is preferred