Provider Enrollment Specialist (Non-Delegated Payer Applications Exp. Req.)

Provider Enrollment Specialist (Non-Delegated Payer Applications Exp. Req.)
Location: Remote – must live in the United States 
Salary: $44,000 - $54,000 + Benefits
Benefits: Health Insurance, 401k w/ match, Paid Holidays, Paid Time Off
Job Type: Full-Time | 100% Remote
Typical Hours: 8:00 AM – 5:00 PM with flexibility, Mon-Fri 
Start Date: ASAP
Sponsorship is not available 

Provider Enrollment Specialist (Non-Delegated Payer Applications Exp. Req.) Description

Our client in the healthcare services industry is looking for a Provider Enrollment Specialist to add to their remote team. In this role, you will manage credentialing and enrollment activities for assigned accounts across multiple states, including non-delegated payer enrollment applications for individual billable providers from start to finish. This includes logging into payer portals, completing applications, tracking payer-specific requirements, resolving enrollment issues, and following each submission through approval and billing readiness. To be considered, you must have direct experience submitting billable provider enrollment applications to individual insurance payers, and following through to participating status under non-delegated contracts, not just supporting credentialing, provider onboarding, or CVO file review. This is a great opportunity to support community-based clinics across 20 states while helping providers enroll and bill without delay.

Provider Enrollment Specialist (Non-Delegated Payer Applications Exp. Req.) Responsibilities

•    Act as the primary contact for assigned accounts across multiple states
•    Independently manage credentialing and provider enrollment for assigned accounts
•    Navigate state-specific processes unique to each payer and state
•    Complete and track provider enrollment applications with commercial and managed care payers
•    Submit individual billable provider applications through payer portals
•    Support Medicare and Medicaid enrollments
•    Maintain and update payer-specific records to support timely approvals
•    Ensure provider data accuracy, including up-to-date CAQH profiles
•    Track application status and respond to payer follow-ups
•    Coordinate payer contracting processes, resolving issues and escalating delays as needed
•    Communicate with payers and providers on enrollment and contracting needs
•    Keep clients informed through regular progress meetings and proactive problem-solving

Provider Enrollment Specialist (Non-Delegated Payer Applications Exp. Req.) Qualifications

•    Direct payer enrollment experience required
•    Experience submitting billable provider applications to insurance payers required
•    Commercial, managed care, Medicare, and/or Medicaid enrollment experience required
•    Proficiency with credentialing/enrollment software and Microsoft Excel required

**Candidates with primarily CVO, delegated credentialing, provider relations, or general credentialing support backgrounds are not a fit unless they have personally owned non-delegated payer enrollment submissions.**