Text copied to clipboard!
Title
Text copied to clipboard!Provider Enrollment Specialist
Description
Text copied to clipboard!
We are looking for a detail-oriented Provider Enrollment Specialist to join our healthcare administration team. The Provider Enrollment Specialist is responsible for managing the enrollment and credentialing processes for healthcare providers within our organization. This role ensures that all providers are properly enrolled with insurance payers, government programs, and other relevant entities, allowing them to deliver services and receive reimbursement in a timely manner. The ideal candidate will have a strong understanding of healthcare regulations, excellent organizational skills, and the ability to communicate effectively with providers, payers, and internal stakeholders.
Key duties include preparing and submitting enrollment applications, maintaining accurate provider records, tracking application statuses, and resolving any issues that may arise during the enrollment process. The Provider Enrollment Specialist will also be responsible for keeping up-to-date with changes in payer requirements and ensuring compliance with all relevant laws and regulations. This position requires a high level of attention to detail, the ability to manage multiple tasks simultaneously, and a commitment to providing excellent customer service to both internal and external clients.
The Provider Enrollment Specialist will collaborate closely with credentialing teams, billing departments, and clinical staff to ensure seamless onboarding and ongoing compliance for all providers. This role may also involve conducting periodic audits of provider files, assisting with re-credentialing processes, and providing training or guidance to other staff members as needed. Strong computer skills, including proficiency with enrollment software and databases, are essential for success in this position.
If you are passionate about supporting healthcare providers and ensuring the smooth operation of healthcare services, we encourage you to apply for this rewarding and impactful role.
Responsibilities
Text copied to clipboard!- Prepare and submit provider enrollment applications to payers and government programs
- Maintain accurate and up-to-date provider records and documentation
- Track the status of enrollment applications and follow up as needed
- Communicate with providers, payers, and internal teams to resolve enrollment issues
- Ensure compliance with all relevant regulations and payer requirements
- Assist with re-credentialing and periodic audits of provider files
- Stay current on changes in enrollment policies and procedures
- Provide training or support to other staff members as needed
- Collaborate with credentialing, billing, and clinical teams
- Respond promptly to inquiries regarding provider enrollment status
Requirements
Text copied to clipboard!- High school diploma or equivalent; associate or bachelor’s degree preferred
- Experience in healthcare administration or provider enrollment
- Strong knowledge of healthcare regulations and payer requirements
- Excellent organizational and time management skills
- Attention to detail and accuracy in data entry
- Strong written and verbal communication skills
- Ability to manage multiple tasks and deadlines
- Proficiency with enrollment software and databases
- Customer service orientation
- Ability to work independently and as part of a team
Potential interview questions
Text copied to clipboard!- What experience do you have with provider enrollment or credentialing?
- How do you ensure accuracy and compliance in your work?
- Describe a time you resolved a challenging enrollment issue.
- What enrollment software or databases are you familiar with?
- How do you prioritize multiple tasks with competing deadlines?
- How do you stay updated on changes in healthcare regulations?
- Describe your communication style when working with providers and payers.
- What steps do you take to maintain confidentiality of provider information?
- How do you handle stressful situations or high workloads?
- Why are you interested in this Provider Enrollment Specialist role?
