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Enrollment / Eligibility Specialist
West Norriton, PA
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Provider Enrollment Specialist Quest Diagnostics Incorporated $60,500.00 / yr flex time, 401(k) Aug 15, 2026
Job Description Provider Enrollment Specialist - West Norriton, PA, Monday to Friday, 8:00 AM to 5:00 PM Pay range: $60,500+ per year Salary offers are based on a wide range of factors including relevant skills, training, experience, education, and, where applicable, certifications obtained. Market and organizational factors are also considered. Successful candidates may be eligible to receive annual performance bonus compensation.
Benefits information:
We are proud to offer best-in-class benefits and programs to support employees and their families in living healthy, happy lives. Our pay and benefit plans have been designed to promote employee health in all respects - physical, financial, and developmental. Depending on whether it is a part-time or full-time position, some of the benefits offered may include: Day 1 Medical, supplemental health, dental & vision for FT employees who work 30+ hours
Best-in-class well-being programs
Annual, no-cost health assessment program Blueprint for Wellness
healthyMINDS mental health program
Vacation and Health/Flex Time
6 Holidays plus 1 "MyDay" off
FinFit financial coaching and services
401(k) pre-tax and/or Roth IRA with company match up to 5% after 12 months of service
Employee stock purchase plan
Life and disability insurance, plus buy-up option
Flexible Spending Accounts
Annual incentive plans
Matching gifts program
Education assistance through MyQuest for Education
Career advancement opportunities
and so much more! Manage, monitor and complete activities related to Provider Enrollment applications, revalidation updates and Credentialing applications as required by the Centers of Medicare & Medicaid Services (CMS) Department of Health (DOH) for Medicare, Medicaid, and Health Plan payers, for Quest, Diagnostics, its subsidiaries, joint ventures and their respective testing facilities. Drive process compliance, controls and standardization utilizing a Centers of Excellence methodology and tools to support and track all Provider Enrollment activities.
Responsibilities:
Review, prepare and submit requests for Medicare, Medicaid, and Health Plan payers to include completion of but not limitedto:provider enrollment applications, revalidation requests, NPI enrollments, licensure updates, CAQH physician credentialing, health plan credentialing, attestations, and disclosures of ownership
Engage with stakeholders such as Health Plans, Legal, Business Development, Compliance, Laboratory Operations and Optum to successfully complete enrollment requests and related activities
Engage with payers directly to discuss enrollment issues, inquiries, updates and due dates of enrollment applications
Review and monitor credentialing reports of enrolled physicians, facilities, and provider groups to proactively submit credentialing applications in advance of payer-defined enrollment/re-enrollment deadlines.
Perform regular updates/additions to the Provider Enrollment Database to ensure enrollment reference data is up to date in advance of the enrollment process
Manage all enrollment activities using worklists in a centralized web-based application such as CRM and finalize the signature process through established state Medicaid web portals and the DocuSign eSignature tool.
Accurately and efficiently submit enrollment and credentialing applications
Effectively manage and update status of enrollments by way of case creation and management
Effectively communicate with agencies, health plans and internalstakeholders'on status of enrollments and credentialing applications
Qualifications:
Required WorkExperience:
3 + years' relevant experience, including working knowledge of Medicare and Medicaid provider network requirements or health plan payer enrollments
Relevant experience in large, complex organizations, commerciallabs, or healthcare organizations
Skills:
Strong analytical and problem-solving skills
Strong interpersonalskills;ability to work with external clients and multiple levels internal
Ability to handle confidential or sensitive information with discretion
Strong written & verbal communication
Strong attention to detail
Strong technical skills in MS Word and Excel
Able to multi-task and perform in a fast-paced environment
Lominger'sCompetencies:
Customer Focus
Organizational Savvy
Learning on the Fly
Problem Solving
Dealing with Ambiguity
Drive for Results Education Bachelor's Degree (Preferred) Competencies Action oriented
Business acumen
Customer Focused
Interpersonal savvy
Organizing
Priority Setting
Time management 66526 Quest Diagnostics honors our service members and encourages veterans to apply. While we appreciate and value our staffing partners, we do not accept unsolicited resumes from agencies. Quest will not be responsible for paying agency fees for any individual as to whom an agency has sent an unsolicited resume.
Equal Opportunity Employer:
Race/Color/Sex/Sexual Orientation/Gender Identity/Religion/National Origin/Disability/Vets or any other legally protected status.