Provider Enrollment Specialist

fabrichealth; United States; On-site; USD 30,000 - 48,000; Full time

Job summary

fabrichealth is seeking a Provider Enrollment Specialist for a focused six-month contract to clear enrollment backlogs and streamline payer workflows. You will own the end-to-end credentialing process with MCOs and state Medicaid, navigating CAQH, NPI data, and TIN attachments to prevent coverage lapses.

You will serve as the primary operational contact for health plan representatives, ensuring enrollment timelines meet regulatory guidelines and official dates are secured.

Qualifications

• Experience in healthcare provider credentialing or payer enrollment.
• Ability to navigate payer portals and verify documentation.
• Capable of tracking enrollment timelines and ensuring regulatory compliance.

Responsibilities

• Execute initial enrollment applications and re-credentialing packets for payers.
• Maintain and attest CAQH profiles, NPI data, and TIN attachments.
• Track pending enrollment applications with MCOs to expedite processing.
• Ensure provider enrollment files meet NCQA/URAC standards.
• Act as primary contact for health plan enrollment representatives.

Skills

Organizational skills

Attention to detail

Analytical skills

Communication skills

Education

High school diploma or GED

Bachelor’s degree

Tools

Availity

PECOS

State Medicaid portals

Job description

About the Role

Delivering rapid, high-quality care requires our clinicians to be fully credentialed and ready to practice. Payer enrollment delays can bottleneck that mission. As a Provider Enrollment Specialist, you will step in for a focused, six-month contract to clear existing enrollment backlogs and streamline our payer application workflows.

You will own the end-to-end credentialing process, working directly with Managed Care Organizations (MCOs) and state Medicaid programs. This role requires navigating complex payer portals, managing CAQH profiles, and acting as the primary point of contact for health plan representatives.

By removing administrative friction, you will ensure our practitioners maintain active network participation. Your work directly accelerates our ability to deploy clinical capacity where it is needed most.

What You'll Do

• Executing initial enrollment applications and re-credentialing packets with commercial and government healthcare payers.
• Maintaining, updating, and attesting CAQH profiles, NPI data, and Tax Identification Number (TIN) attachments to prevent coverage lapses.
• Tracking pending enrollment applications with MCOs and health plans to expedite processing and secure official effective dates.
• Ensuring all provider enrollment files meet MCO standards and regulatory guidelines from bodies like NCQA and URAC.
• Serving as the primary operational contact for health plan enrollment representatives regarding application status, roster updates, and credentialing inquiries.

Why You Might Be a Good Fit

• You are highly organized and rarely let details slip through the cracks.
• You navigate complex bureaucratic systems with patience and persistence.
• You thrive in focused, project-based work where you can see immediate results.
• You communicate clearly and concisely with clinicians, internal teams, and external payers.

This Might Not Be The Right Fit If...

• You prefer a permanent, long-term role rather than a six-month contract.
• You get frustrated by repetitive administrative processes and frequent payer follow-ups.
• You need a highly structured, slow-moving environment to feel comfortable.

Your Qualifications

• One to three years of experience in healthcare provider credentialing, payer enrollment, or managed care onboarding.
• High school diploma or GED.
• Demonstrated proficiency with payer enrollment portals like Availity, PECOS, and state Medicaid systems.
• Deep understanding of payer-specific credentialing rules, state licensing standards, and enrollment timelines.
• Strong analytical skills to identify missing documentation and resolve enrollment delays independently.

Bonus Points

• Bachelor’s degree.
• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) certification.
• Experience working with virtual care platforms or multi-state telehealth providers.

The national pay range for this role is $22.00 – $35.00 per hour. Actual compensation will be determined by factors such as the candidate's geographic market, experience, skills, and qualifications. If your compensation requirement is greater than our posted range, please still consider applying; a determination can be made based on unique qualifications. Expected compensation ranges for this role may change over time.