Provider Enrollment Specialist

As a Provider Enrollment Specialist, you'll be responsible for assisting with the administration of the provider enrollment process for assigned new and existing providers. You'll also be responsible for assisting in obtaining and maintaining information essential to complete the credentialing/re-credentialing process.

* Prepare and submit enrollment applications for practitioners, group practices, and facilities.
* Manage new enrollments from start to finish, ensuring providers are enrolled with all assigned payers.
* Track and follow up on enrollment applications using Smart Sheets, maintaining detailed logs of tasks.
* Regularly update and communicate enrollment status to stakeholders.
* Maintain provider portals such as Wybtrak/CAQH, ensuring all data is up-to-date.
* Contact practitioners, insurance representatives, and provider staff to compile necessary provider data.
* Comply with NCQA, Medicare, and Medicaid standards, as well as HIPAA guidelines and department procedures.
* Assist with updating fee schedules for Medicare, Medicaid, and commercial payers in NextGen EPM.
* Proactively resolve any issues that arise during the enrollment process.
* Perform other duties as assigned.

Must-Have Skills
* Experience in medical records and medical office settings.
* Strong data entry skills and ability to make follow-up calls to insurance plans.

Nice-to-Have Skills
* Knowledge of NPPES.
* Experience with provider enrollment.

Schedule
* Monday to Friday 8:00am to 5:00pm

Pay Rate
* $21 to $23 an hour