Provider Enroll Specialist - Patient Financial Service - FT Days

Sky Lakes; Klamath Falls (OR); Hybrid; USD 33,000 - 48,000; Full time

Job summary

Ultipro is seeking a Provider Enrollment Specialist to manage enrollment and re-enrollment for Medicare, Medicaid, managed care, and commercial plans. You will maintain MD-Staff records, track statuses, and work with payers and internal teams to ensure continuous active status.

Ideal candidates have 2+ years in provider enrollment or credentialing, familiarity with CAQH, NPPES, PECOS, and MD-Staff, and strong MS Office skills.

Qualifications

• 2+ years in provider enrollment, credentialing, or healthcare administration.
• Experience with Medicare, Medicaid, managed care, and commercial plans.
• Familiar with CAQH, NPPES, PECOS, and MD-Staff; strong MS Office skills.
• High school diploma required; bachelor’s degree preferred.

Responsibilities

• Prepare and submit enrollment applications to Medicare, Medicaid, managed care, and other plans.
• Manage recredentialing, revalidation, and re-enrollment to maintain active status.
• Monitor statuses, follow up with payers, and respond to RFIs.
• Maintain profiles in CAQH, NPI Registry, PECOS, and MD-Staff.
• Generate reports and provider rosters for payers.
• Collaborate with Credentialing, Revenue Cycle, Contracting, and Clinics.
• Coordinate with payer relations to resolve discrepancies.
• Ensure compliance with federal and state enrollment guidelines.
• Submit rosters every 90 days for FNSA compliance.
• Assist Credentialing with initial and recredentialing; support verification.
• Maintain credentialing files for audit readiness.
• Coordinate onboarding to align credentialing and enrollment timelines.

Skills

Provider enrollment

Credentialing

Healthcare administration

CAQH

NPPES

PECOS

MD-Staff

Microsoft Office

Email management

Education

High school diploma

Bachelor's degree in healthcare administration

Tools

CAQH

NPPES

PECOS

MD-Staff

Job description

Provider Enroll Specialist - Patient Financial Service - FT Days

Job Category: Professional

Requisition Number: PROVI003322

• Posted : October 8, 2026
• Full-Time
• On-site
• Hourly Range : $23.89 USD to $35.84 USD

Locations

Showing 1 location

Description

POSITION SUMMARY

The Provider Enrollment Specialist is responsible for managing and coordinating the provider enrollment and re-enrollment process for all healthcare providers as well as facility enrollment and re-enrollment with payers. This includes preparing and submitting enrollment applications for Medicare, Medicaid, managed care plans, commercial and government insurance plans, as well as out-of-state payers. The role also includes maintaining MD-Staff as the system of record for provider enrollment, ensuring accurate and up-to-date provider data, tracking enrollment status and key dates, and ensuring continuous active status with payers. This position requires close collaboration with various internal departments to support provider credentialing, onboarding and payer enrollment. It also requires close communication with payers, providers, clinic leadership and internal staff to resolve enrollment issues, track applications, and ensure compliance with all regulatory and organizational requirements.

QUALIFICATIONS

P referred: The ideal candidate for the Provider Enrollment Specialist position should have a minimum of two (2) years of experience in provider enrollment, credentialing, or healthcare administration. Experience with enrollment processes for Medicare, Medicaid, managed care plans, and commercial insurance preferred. Candidates should also be familiar with various provider databases such as CAQH and NPPES, PECOS and MD-Staff or similar credentialing/enrollment database systems. Proficiency with Microsoft Office applications and the ability to effectively manage email and electronic workflows across multiple systems is required. Strong organizational skills, attention to detail, and the ability to manage multiple priorities in a fast-paced environment are essential. Candidates must also demonstrate excellent written and verbal communication skills, particularly in liaising with internal departments and external stakeholders like payers and providers. A high school diploma or equivalent is required.

P referred: Bachelor's degree in healthcare administration or a related field is preferred.

TYPICAL PHYSICAL/MENTAL DEMANDS

This position requires long periods of sitting and working at a computer, including data entry and handling electronic communication. The role may require occasional lifting of files or office supplies up to 10 pounds. Mentally, the job demands high attention to detail, problem-solving skills, and the ability to multi-task in a fast-paced, deadline-driven environment. The employee must possess good communication and interpersonal skills, as well as the ability to adapt to changes in regulations and payer requirements.

ESSENTIAL JOB FUNCTIONS:

• Prepare and submit new enrollment applications for providers and the facility to Medicare, Medicaid, Managed Care plans, and other insurance carriers.
• Manage recredentialing revalidation and re-enrollment processes to ensure providers and facility maintain continuous active status with payers.
• Monitor application statuses, track application aging, and conduct routine follow up with payers to resolve issues, respond to Requests for Information (RFIs), and secure network participation.
• Maintain and update provider profiles in CAQH, NPI Registry, PECOS, and MD-Staff to ensure alignment with enrollment submissions.
• Maintain MD-Staff database as the system of record for provider enrollment, including accurate data entry, status tracking key dates, and documentation of payer communications.
• Generate and maintain reports and provider rosters for payers from MD-Staff to support operational visibility and compliance requirements.
• Collaborate with internal stakeholders, including Credentialing, Revenue Cycle, Contracting, and Clinics, to support provider enrollment, ensure billing readiness, and facilitate timely reimbursement.
• Establish and maintain relationships with payer Provider Relations Representatives to resolve enrollment discrepancies, elevate delays and improve turnaround times.
• Ensure compliance with federal, state, and departmental guidelines related to provider enrollment.
• Submit rosters to various payers every 90 days to maintain compliance with the Federal No Surprises Act (FNSA).
• Support centralized tracking and visibility of enrollment activity, including identifying backlogs, upcoming expirations, and high-priority enrollments impacting revenue.
• Assist with facility and clinic provider data management, ensuring accurate contact details for locations.
• Assist the Credentialing team with initial credentialing and recredentialing applications as needed, as well as support primary source verification activities during peak volumes or staff absences.
• Assist with the maintenance of credentialing files to ensure audit readiness.
• Coordinate with Credentialing team on provider onboarding to align credentialing and enrollment times.

MARGINAL JOB FUNCTIONS:

• Performs other duties as assigned.

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.