Provider Enrollment Specialist Full Time

This role operates within a complex healthcare credentialing and payer enrollment environment, ensuring that medical providers and facilities are accurately enrolled, recredentialed, and maintained across managed care, Medicare, Medicaid, and other governmental plans. You will serve as a key coordinator between providers, internal administrative teams, and external payers, helping ensure timely onboarding and uninterrupted revenue flow. The position requires strong attention to detail, regulatory awareness, and the ability to manage multiple enrollment workflows simultaneously. You will also act as a communication hub, ensuring stakeholders are informed of provider status and participation updates. Working in a fast-paced healthcare system environment, you will directly contribute to operational efficiency and compliance. This is a highly collaborative role that blends administrative precision with stakeholder engagement.

Accountabilities

• Coordinate and support the provider enrollment, credentialing, and recredentialing processes across multiple payer systems including Medicare, Medicaid, and managed care organizations.
• Track, maintain, and update enrollment databases with accurate provider information, certifications, and effective participation dates.
• Serve as a liaison between providers, onboarding teams, hiring managers, and payer representatives to ensure smooth enrollment workflows.
• Monitor licensing, certifications, and credentialing documentation to ensure compliance with regulatory and accreditation requirements.
• Develop and maintain reporting tools to track enrollment status, identify delays, and support revenue cycle continuity.
• Communicate provider participation updates to internal departments to support scheduling and billing accuracy.
• Troubleshoot enrollment issues, analyze discrepancies, and escalate complex cases when needed.
• Provide guidance and support on credentialing processes to internal stakeholders and external partners.

Requirements

• High school diploma or equivalent required.
• 2+ years of experience in healthcare operations, preferably in provider enrollment, credentialing, physician office, or professional billing.
• Strong understanding of healthcare payer systems, managed care structures, and basic credentialing regulations.
• High attention to detail with strong analytical, organizational, and problem-solving skills.
• Ability to manage multiple priorities in a fast-paced, regulated environment with minimal supervision.
• Proficiency in Microsoft Office tools including Word, Excel, Outlook, and Access.
• Strong communication and interpersonal skills with the ability to collaborate across clinical, administrative, and external stakeholders.
• Ability to maintain confidentiality and handle sensitive provider information appropriately.

Benefits

• Full-time schedule (Monday-Friday, standard business hours).
• Comprehensive healthcare system employment environment with stable long-term opportunities.
• Exposure to large-scale provider networks and complex healthcare operations.
• Opportunities for professional growth in credentialing and revenue cycle administration.
• Collaborative, mission-driven workplace focused on healthcare access and operational excellence.
• Standard benefits package typically including health coverage, retirement options, and paid time off (based on employer policies).
• Structured onboarding and support within a large healthcare organization.

How Jobgether Works

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role’s core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.