Provident Enrollment

Description

• Prepare and submit enrollment and re-enrollment applications for healthcare providers to Medicare, Medicaid, and commercial insurance plans.
• Maintain accurate and up-to-date provider records in internal databases and payer portals.
• Track application statuses and follow up with payers to ensure timely processing.
• Collaborate with providers and credentialing staff teams to gather required documentation and resolve discrepancies.
• Monitor and manage re-credentialing and revalidation timelines to ensure continuous participation.
• Respond to inquiries from providers and internal departments regarding enrollment status and requirements.
• Assist with audits and reporting related to provider enrollment activities.

Skills

Customer service, credentialing, provider enrollment

Qualifications

• High school diploma or equivalent required; associate or bachelor’s degree in healthcare administration or related field preferred.
• 2 years of experience in provider enrollment or credentialing.
• Ability to work independently in a remote setting and manage a distributed workload.
• Strong understanding of Medicare, Medicaid, and commercial insurance enrollment processes.
• Excellent organizational, communication, and problem-solving skills.
• Ability to manage multiple tasks and meet deadlines in a fast-paced environment.
• Requires a high level of accountability and self-management.
• Familiarity with CAQH.