Provider Enrollment Specialist
Fully Remote Remote
Job Type
Full-time
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