Medicaid Provider Enrollment Specialist

Socket.dev; Franklin (TN); On-site; USD 42,000 - 65,000; Full time

Job summary

EnableComp is hiring a Provider Enrollment Specialist, Medicaid, to oversee and maintain the professional and facility enrollment process. You will submit online and paper applications and handle PHI with strict privacy and security.

The role requires developing state-specific enrollment policies, maintaining up-to-date knowledge of Medicaid rules, and coordinating with leadership to ensure timely submissions and compliance.

Qualifications

• High School Diploma or GED required; further degree preferred.
• 1+ years’ experience in healthcare billing or collections.
• 1+ years’ client facing/customer service experience.
• Understanding of payer/provider claims processing and data needs.
• Knowledge of enrollment requirements and documents for applications.

Responsibilities

• Collect, verify, and submit information for enrollment of hospitals/physicians with Out-of-State Medicaid payers.
• Develop and maintain enrollment policies and procedures by state.
• Maintain knowledge of Medicaid enrollment requirements; educate internal team members.
• Submit re-enrollment applications timely to keep enrollment active.
• Ensure compliance with government rules for Out-of-State Medicaid.
• Manage work queue for payor-specific forms and documents to health plans.
• Maintain provider file updates and communicate changes in the database.

Skills

Healthcare billing

Customer service

Claims processing

MS Office proficiency

Education

High School Diploma or GED

Associates or Bachelor's degree preferred

Tools

Microsoft Office

Job description

EnableComp is hiring a Provider Enrollment Specialist, Medicaid, to oversee and maintain the professional and facility enrollment process. You will submit online and paper applications and handle PHI with strict privacy and security.

The role requires developing state-specific enrollment policies, maintaining up-to-date knowledge of Medicaid rules, and coordinating with leadership to ensure timely submissions and compliance.