Provider Enrollment Specialist

Description

Pay Rate: Up to $28/hour based on experience

Schedule: Mon-Fri 8-5 CST

Location: Remote

This role is intended to improve enrollment turnaround, reduce dollars on hold, and provide consistent ownership of enrollment-related system work across all payers by supporting payer enrollment execution and revenue growth, with a primary focus on Athena enrollment dashboards, worklists, and payer setup tasks.

Provider Enrollment Specialist Job Duties:

• Manages the timely and accurate submission of provider enrollment applications for all insurance types, including enrollment and reassignment of Medicaid, Managed Medicaid, and commercial programs.
• Own and work the Athena enrollment-related tasks daily.
• Tracks and updates enrollment statuses on a real-time basis.
• Maintains the timelines for all enrollment schedules and provides updates to others as needed.
• Updates and maintains CAQH profiles to ensure data is accurate, attestations are current, and do not expire.
• Coordinates the receipt and processing of all credentialing data needed for enrollment, contracting, and other related purposes.
• Works closely with providers to obtain missing documentation for provider’s enrollment.
• Obtains required provider signatures and follows up with the carriers on documentation submitted.
• Responds to internal and external inquiries on enrollment and contract matters.
• Performs other duties as required or assigned within the scope of responsibility, including supporting other functions and teams within the Revenue Cycle.

Requirements

• Prior experience in payer or provider enrollment or enrollment operations (3 years minimum experience)
• Hands-on experience working in Athena (payer setup, enrollment dashboards, or worklists) required
• Salesforce experience preferred
• Medicaid and Medicaid Enrollment experience required
• Experience working with payer portals required
• Multi-payer and multi-state enrollment experience required
• Understanding of enrollment dependencies such as:
  • Provider vs group enrollment
  • EFT / ERA
  • Pay-to setup
  • Strong organizational skills and follow-through