Medical Provider Enrollment Specialist

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 :

Mandatory Requirements :

Compensation : Monthly Salary