Job Summary
We are seeking a proactive and detail-oriented Provider Enrollment Specialist to join our dynamic healthcare team. In this vital role, you will be responsible for managing the enrollment process for healthcare providers with various managed care organizations, ensuring compliance with industry standards and regulatory requirements.
Duties
- Coordinate and manage the enrollment process for new healthcare providers with multiple managed care plans and payers
- Verify provider credentials, licensing, and certifications to ensure compliance with regulatory standards
- Prepare and submit all necessary documentation for provider enrollment applications accurately and efficiently
- Track application statuses, follow up on pending items, and resolve any issues that may delay enrollment
- Maintain detailed records of all provider enrollment activities in accordance with organizational policies
- Collaborate with medical offices and internal teams to gather required information and facilitate smooth onboarding
- Ensure all provider information aligns with NCQA standards and other applicable accreditation requirements
Qualifications
- Proven experience in managed care or healthcare provider enrollment processes
- Prior medical office experience is highly desirable, providing familiarity with clinical workflows and terminology
- Strong understanding of medical terminology and healthcare regulations
- Excellent organizational skills with attention to detail and accuracy
- Ability to communicate effectively across teams and external organizations
- Proficiency in using healthcare management software or databases
Join us in a role where your efforts directly impact the efficiency of healthcare delivery! We value motivated professionals eager to make a difference by ensuring providers are enrolled seamlessly, supporting our mission to deliver exceptional patient care.
Pay: $3,000.00 - $5,000.00 per month
Benefits:
Work Location: Remote
