Provider Enrollment Specialist

This is a fully remote position, open to applicants in New York.

📋 Description

• Prepare, submit, and track enrollment applications for new providers as well as modifications for existing providers.

• Ensure accurate documentation of enrollment activities within the credentialing system.

• Liaise with insurance companies, healthcare providers, and internal departments.

• Monitor the status of enrollments and follow up with payers to address any delays or issues.

• Update provider demographic details and practice information with contracted payers.

• Maintain timelines and requirements for recredentialing.

• Work collaboratively with Field Support, Operations, and Revenue Cycle Management teams on escalated matters.

• Investigate and resolve issues related to out-of-network claims.

• Manage temporary provider enrollments and complete necessary documentation, linkage, and payer updates.

• Partner with RCM to monitor provider enrollment status and generate reports as necessary.

• Create and maintain reports on enrollment status.

• Assist with audits and perform additional duties as assigned.

⛳️ Requirements

• High school diploma or equivalent is mandatory.

• An Associate or Bachelor’s degree is preferred.

• 1–3 years of experience in payer enrollment is required.

• Familiarity with commercial payers and government payer requirements is essential.

• Proficient in Microsoft Office and credentialing software such as CAQH and Availity.

• Strong attention to detail, organizational skills, and ability to follow up effectively.

• Excellent communication and customer service skills when interacting with both internal teams and external clients.

• Strong analytical and problem-solving capabilities.

• Experience with multi-specialty large group practices is preferred; knowledge of dentistry is a plus.

• Understanding of revenue cycle and billing processes is preferred.

• Familiarity with NPI and provider management is preferred.

🏝️ Benefits

• Paid time off

• Health insurance

• Dental insurance

• Vision insurance

• 401(k) savings plan with match