Medical Provider Enrollment Specialist (Permanent Work-From-Home)

Medical Provider Enrollment Specialist (Permanent Work-From-Home)

About the Role : We are seeking experienced Medical Provider Enrollment Specialists with a strong background in end-to-end Provider Enrollments, Insurance Credentialing, Provider Contracting, and ReCredentialing. This role is ideal for professionals who thrive in a remote work environment and are committed to maintaining clear communication with our credentialing team and clients. Attention to detail and the ability to flawlessly complete tasks within set deadlines are essential for this position.

Key Responsibilities :

Manage the full spectrum of provider credentialing and enrollment, including filing Letters of Interest and completing enrollment applications for all states.

Engage with payers via calls and emails to ensure the successful processing of both individual and group applications.

Demonstrate expertise in submitting required documentation for private commercial payors, Medicare, Medicaid, Medicaid MCO, and Medicare supplement / replacement plans.

Maintain regular communication with clients, providing updates and ensuring the active status of providers with payers.

Handle end-to-end processes for creating and maintaining provider details on platforms such as CAQH, PECOS, Availity, Navinet, NPPES, and other provider portals.

Manage the application and renewal process for all provider licenses, including Professional, DEA, and Controlled Substance licenses.

Ensure continuous updating and maintenance of client and application data, readily available for client requests.

Requirements :

A minimum of 5 years of experience in provider credentialing and enrollment.

Strong organizational skills and the ability to work independently in a remote setting.

Proficiency in using credentialing portals and managing the associated documentation.

Exceptional communication skills to effectively engage with both clients and payers.

Mandatory Requirements :

Has a fast dedicated laptop / PC I5+, 8GB Ram, Windows 10 / 11 (licensed and activated), MS Office 2013 + (working copy).

Quiet home office with no distractions

Have at least 1 year of experience working from home successfully during EST hours

Minimum dedicated fast internet 50MB+ (must be fiber or cable into your home)

9am-6pm EST Mon-Fri shift.

Compensation : Monthly Salary