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Now viewing: Provider Enrollment Specialist
RH
Robert Half
Provider Enrollment Specialist
Job Description
A healthcare company is seeking Provider Enrollment Specialists to provide immediate support to a growing healthcare team managing a significant backlog. This Provider Enrollment Specialist is ideal for professionals with prior provider enrollment and healthcare credentialing experience who can step in quickly, work independently, and help improve turnaround times and overall workflow.
Review provider files for accuracy, completeness, and compliance with payer and regulatory requirements. Verify licenses, certifications, education, training, and other required provider documentation. Track application status, renewals, expirables, and follow-up items to ensure timely completion. Communicate with providers, payers, and internal departments regarding enrollment status, missing items, and issue resolution. Maintain accurate records and update provider information in internal databases and systems. Assist in reducing enrollment and credentialing backlog while meeting quality and productivity expectations. Ensure all activities are completed in accordance with organizational policies, payer guidelines, and regulatory standards.
Key Responsibilities:
Process provider enrollment applications and related documentation for health plans, payers, and networks. Support credentialing and recredentialing activities as needed to ensure providers are properly enrolled and maintained.Review provider files for accuracy, completeness, and compliance with payer and regulatory requirements. Verify licenses, certifications, education, training, and other required provider documentation. Track application status, renewals, expirables, and follow-up items to ensure timely completion. Communicate with providers, payers, and internal departments regarding enrollment status, missing items, and issue resolution. Maintain accurate records and update provider information in internal databases and systems. Assist in reducing enrollment and credentialing backlog while meeting quality and productivity expectations. Ensure all activities are completed in accordance with organizational policies, payer guidelines, and regulatory standards.