Provider Enrollment & Credentialing Specialist

Sky-Lakes-Medical-Center; Klamath Falls (OR); On-site; USD 33,000 - 49,000; Full time

Job summary

Ultipro is seeking a Provider Enroll Specialist in a full-time, on-site role in Oregon. You will manage provider enrollment and re-enrollment with Medicare, Medicaid and commercial payers, coordinate with Credentialing and Revenue Cycle, and ensure ongoing enrollment compliance across multiple databases.

The position requires a minimum of two years in enrollment/credentialing and strong organizational skills, with proficiency in MD-Staff, CAQH, NPPES, PECOS, and Microsoft Office.

Qualifications

• 2+ years of provider enrollment, credentialing, or healthcare administration experience.
• Experience with Medicare/Medicaid, managed care, and commercial plans.
• Strong written and verbal communication and ability to liaise with internal/external stakeholders.

Responsibilities

• Prepare and submit enrollment applications for providers and facilities to Medicare, Medicaid, and other plans.
• Manage recredentialing and re-enrollment to maintain active payer status.
• Track application statuses and follow up with payers to resolve RFIs and delays.
• Maintain provider profiles in CAQH, NPI Registry, PECOS, and MD-Staff.
• Maintain MD-Staff as the system of record for enrollment data and communications.
• Generate reports and provider rosters for payer visibility and compliance.

Skills

Enrollment experience

Communication skills

Education

High school diploma

Bachelor's degree in healthcare administration preferred

Tools

CAQH

NPPES

PECOS

MD-Staff

Microsoft Office

Job description

Ultipro is seeking a Provider Enroll Specialist in a full-time, on-site role in Oregon. You will manage provider enrollment and re-enrollment with Medicare, Medicaid and commercial payers, coordinate with Credentialing and Revenue Cycle, and ensure ongoing enrollment compliance across multiple databases.

The position requires a minimum of two years in enrollment/credentialing and strong organizational skills, with proficiency in MD-Staff, CAQH, NPPES, PECOS, and Microsoft Office.