Provider Enrollment Specialist in United States at Jobgether

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Provider Enrollment Specialist in the United States.

This role plays a key part in ensuring healthcare providers are properly enrolled, credentialed, and maintained within payer networks to support accurate reimbursement and uninterrupted patient care. You will operate in a complex regulatory and payer environment, managing enrollment and recredentialing processes across managed care, Medicare, Medicaid, and other governmental programs. The position requires close coordination with providers, internal administrative teams, and external payer representatives to ensure timely and compliant processing. You will act as a central liaison, guiding providers through onboarding and enrollment workflows while maintaining accurate data systems and tracking tools. With a strong focus on accuracy, compliance, and revenue integrity, this role directly impacts organizational efficiency and financial performance. It is ideal for someone who thrives in structured, detail-driven healthcare operations with strong communication and problem-solving skills.

• Support the full provider enrollment, credentialing, and recredentialing lifecycle across managed care, Medicare, Medicaid, and governmental payer programs.
• Serve as a concierge-style point of contact, guiding providers through onboarding, enrollment, and revalidation processes.
• Maintain and update enrollment databases, ensuring accurate tracking of provider status, effective dates, and payer participation.
• Monitor documentation, licenses, and certifications to ensure compliance and active provider status across all markets.
• Track enrollment packet completion and proactively escalate issues to hiring managers or recruiters when delays occur.
• Develop and maintain reporting tools to communicate enrollment status, timelines, and revenue impact to leadership and billing teams.
• Coordinate with administrators and operational leaders to support new service lines, facilities, and provider onboarding under existing contracts.
• Analyze enrollment and credentialing issues, troubleshoot discrepancies, and recommend or escalate corrective actions.
• Act as a knowledge resource for internal teams and external stakeholders regarding enrollment policies and processes.
• Maintain strict confidentiality while ensuring compliance with regulatory and accreditation standards.

• High school diploma or equivalent required.
• Minimum of 2 years of experience in healthcare-related environments.
• Preferred experience in professional billing, physician office operations, credentialing, or provider enrollment.
• Strong understanding of healthcare payer systems, credentialing processes, and regulatory requirements.
• Proficiency in Microsoft Office tools, including Word, Excel, Access, and Outlook.
• Strong analytical, problem-solving, and organizational skills with high attention to detail.
• Ability to manage multiple priorities in a fast-paced, deadline-driven environment.
• Strong communication skills with the ability to interact effectively with providers, administrators, and payer representatives.
• Ability to work independently while maintaining strong collaboration with cross-functional teams.
• Strong interpersonal skills with a service-oriented and solutions-focused mindset.

• Standard weekday schedule (Monday–Friday, 8:00 AM–5:00 PM).
• Remote work arrangement within the United States.
• Competitive compensation aligned with experience.
• Comprehensive healthcare coverage (medical, dental, and vision).
• Paid time off and paid holidays.
• Retirement savings options.
• Supportive and structured work environment within a healthcare system.
• Opportunity to contribute to revenue integrity and patient access outcomes.
• Exposure to complex payer and regulatory healthcare operations.
• Professional development within healthcare administration and credentialing functions.