Sr. Provider Enrollment Specialist
$57,750–$97,604 year
Remote · United States
Job Summary
Lead Provider Enrollment Lead overseeing the provider enrollment lifecycle to ensure timely and accurate enrollment with payers and credentialing across commercial, Medicare, and Medicaid. Manage enrollment applications and supporting documentation, monitor timelines, and minimize delays. Maintain knowledge of payer enrollment requirements, regulations, and industry standards. Enter and audit provider demographic and credentialing data in internal systems and payer portals; track license renewals, CAQH attestation, and NPI registrations. Resolve enrollment issues by liaising with payers, providers, and internal teams; escalate as needed. Ensure compliance with federal, state, and payer guidelines; maintain organized records and assist with audits. Collaborate with Revenue Cycle, Provider Relations, and Credentialing teams to align enrollment efforts and drive process improvements for faster, accurate onboarding and enrollment.
Required Qualifications
- Associate’s degree in Healthcare Administration, Business, or related field required (Bachelor’s preferred)
- Minimum of 3-5 years of experience in provider enrollment, credentialing, or revenue cycle operations
- Strong understanding of payer enrollment processes for commercial, Medicare, and Medicaid plans
- Experience working with provider enrollment portals (e.g., PECOS, CAQH, Availity) and electronic credentialing systems
- Ability to analyze enrollment data and resolve complex payer or application issues effectively
- Proficiency in Microsoft Office Suite and experience with healthcare information systems (EHR, practice management systems)
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