Provider Enrollment Specialist

St. Luke’s University Health Network; Allentown (Lehigh County); On-site; USD 42,000 - 64,000; Full time

Job summary

St. Luke's University Health Network is seeking a Provider Enrollment Specialist to manage initial and re-credentialing applications with payers and maintain licensure for providers.

This role will also track enrollment data, communicate with practice managers, and ensure timely submission of enrollment materials. The position requires strong MS Office skills, excellent customer service, and clear written and verbal communication.

Qualifications

• Experience with personal computers and the Microsoft Office suite of products is required.
• Strong customer service skills.
• Excellent verbal and written communication skills.
• Detail and service oriented.

Responsibilities

• Prepares provider enrollment applications and/or written link letters to be sent to payers.
• Ensures all providers and groups are re-validated with payers on a timely basis by completing re-credentialing applications with current provider information and signatures.
• Makes and receives phone calls from providers and practice managers to help resolve payer issues and verify participating status.
• Updates & maintains database to show enrollment tracking, effective dates, provider numbers and correct provider demographics.
• Scans and files all paperwork and documents to a shared folder for tracking purposes and proof of submission to payers.
• Applies for New Jersey licensure for identified providers.
• Creates and submits new group enrollment applications for newly opened or moving practices.
• Fields and responds timely to inquiries from SLUHN departments to help resolve enrollment related issues.
• Ensures SLUHN billing department has resolution on enrollment issues that assist with claim processing.
• Identifies and communicates current or potential enrollment issues that could result in loss of revenue and/or patient dissatisfaction.
• Participates in team meetings and conference calls with payers.
• Completes online applications for Doing Business As (DBA) for new or renamed groups.
• Creates check requests for out-of-state enrollment fees.

Skills

Customer service

Verbal communication

Written communication

Attention to detail

PC skills

MS Office

Education

High School Diploma

Tools

Microsoft Office

Job description

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. The Provider Enrollment Specialist ensures that initial and re-credentialing applications for St. Luke’s University Health Network (SLUHN) employed providers’ are submitted to identified third party and government health insurance carriers. Responsibilities also include maintaining membership and renewal information for professional and DEA licenses, board certification and professional organization memberships.

Job Duties and Responsibilities

• Prepares provider enrollment applications and/or written link letters to be sent to payers
• Ensures all providers and groups are re-validated with payers on a timely basis by completing re-credentialing applications with current provider information and signatures
• Makes and receives phone calls from providers and practice managers to help resolve payer issues and verify participating status
• Updates & maintains database to show enrollment tracking, effective dates, provider numbers and correct provider demographics
• Scans and files all paperwork and documents to a shared folder for tracking purposes and proof of submission to payers
• Applies for New Jersey licensure for identified providers
• Creates and submits new group enrollment applications for newly opened or moving practices
• Fields and responds timely to inquiries from SLUHN departments to help resolve enrollment related issues
• Ensures SLUHN billing department has resolution on enrollment issues that assist with claim processing
• Identifies and communicates current or potential enrollment issues that could result in loss of revenue and/or patient dissatisfaction
• Participates in team meetings and conference calls with payers
• Completes online applications for Doing Business As (DBA) for new or renamed groups
• Creates check requests for out-of-state enrollment fees

Physical and Sensory Requirements

• Requires sitting for up to eight hours per day, including extensive use of computer terminal and telephone
• Requires hearing as it relates to normal conversation and answering questions in large groups
• Requires seeing as it relates to general near and far vision

Education

High School Education

Training and Experience

• Experience with personal computers and the Microsoft Office suite of products is required
• Strong customer service skills
• Excellent verbal and written communication skills
• Detail and service oriented

St. Luke's University Health Network is an Equal Opportunity Employer.

Founded in 1872, St. Luke’s University Health Network (SLUHN) is a fully integrated, regional, non-profit network of more than 23,000 employees providing services at 16 campuses and 350+ outpatient sites. With annual net revenue in excess of $4 billion, the Network’s service area includes 11 counties in two states: Lehigh, Northampton, Berks, Bucks, Carbon, Montgomery, Monroe, Schuylkill and Luzerne counties in Pennsylvania and Warren and Hunterdon counties in New Jersey. St. Luke’s hospitals operate the largest network of trauma centers in Pennsylvania, with the Bethlehem Campus being home to St. Luke’s Children’s Hospital. SLUHN is the only Lehigh Valley-based health care system to earn Medicare’s five-star ratings (the highest) for quality, efficiency and patient satisfaction. It is both a Leapfrog Group and Healthgrades Top Hospital and a Newsweek World’s Best Hospital. The Network’s flagship University Hospital has earned the 100 Top Major Teaching Hospital designation from Premier 13 times total and eleven years in a row, including in 2023 when it was identified as THE #4 TEACHING HOSPITAL IN THE COUNTRY. In 2021, St. Luke’s was identified as one of the 15 Top Health Systems nationally. St. Luke’s is the ONLY health care institution in the Lehigh Valley to be named a Top Workplace regionally repeating the exclusive honor for the third year in a row. Also, for the third straight year, St. Luke’s has been a Top Workplaces in the Philadelphia Region by the Philadelphia Inquirer, ranking 9th in the large employer category for 2025 and the only health care system in PA to receive this award. In 2025, St. Luke’s was recognized as a national Top Workplaces by USA Today, three years in a row, including the 3rd best health care system in the nation in 2023 and 2024. Lastly, in 2025, St. Luke’s was named a Top Workplace in New Jersey for the third year in a row.