Enrollment Expert

About the Role :

We are seeking a highly skilled Medical Provider Enrollment Specialist to join our team. As a key member of our organization, you will be responsible for managing the full spectrum of provider credentialing and enrollment.

This includes filing Letters of Interest and completing enrollment applications for all states. You will engage with payers via calls and emails to ensure the successful processing of both individual and group applications.

To succeed in this role, you must demonstrate expertise in submitting required documentation for private commercial payors, Medicare, Medicaid, Medicaid MCO, and Medicare supplement / replacement plans.

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

Your responsibilities will also include handling end-to-end processes for creating and maintaining provider details on platforms such as CAQH, PECOS, Availity, Navinet, NPPES, and other provider portals.

In addition, you will manage the application and renewal process for all provider licenses, including Professional, DEA, and Controlled Substance licenses.

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

Key Responsibilities :

• Filing Letters of Interest and completing enrollment applications for all states.
• Engaging with payers via calls and emails to ensure successful application processing.
• Demonstrating expertise in submitting required documentation for various payors.
• Maintaining regular communication with clients and ensuring provider status.
• Handling end-to-end processes for creating and maintaining provider details.
• Managing the application and renewal process for provider licenses.

Requirements :