Remote Provider Enrollment & Credentialing Specialist

Remote Jobs; Richardson (TX); Remote; USD 50.000 - 70.000; Vollzeit

Benefits dieser Stelle

Discretionary bonus

Comprehensive benefits package

Zusammenfassung

National Partners in Healthcare (NPH) is seeking a Provider Enrollment Specialist for a remote role with residency requirements in AZ, TX, TN, NH, FL, or NC. The position focuses on managing enrollment and revalidation with government and commercial payers to ensure timely reimbursement.

You will work with credentialing, billing, and contracting teams to track status, resolve discrepancies, and maintain accurate provider data. Strong attention to detail and communication are essential.

Qualifikationen

• Associate's degree in Business Administration (BA) or related field, or equivalent combination of education and experience required.
• Two years of credentialing experience required.
• A minimum of two-five years' experience and proven proficiency in provider enrollment payer credentialing required.

Aufgaben

• Prepare, submit, and track provider enrollment, revalidation, and recredentialing applications with government and commercial payers (e.g., Medicare, Medicaid, commercial insurance plans).
• Maintain current and accurate provider demographic, licensure, certification, and contract information in enrollment systems, credentialing databases, and payer portals.
• Serve as the primary point of contact for providers regarding enrollment status, documentation requirements, timelines, and payer correspondence.
• Review enrollment applications for completeness, accuracy, and compliance with payer and regulatory requirements prior to submission.
• Communicate regularly with payer representatives to resolve application discrepancies, follow up on pending submissions, and address denials or terminations.
• Coordinate with internal departments such as credentialing, billing, compliance, and contracting to ensure alignment of provider data and minimize claim rejections.
• Monitor enrollment statuses and proactively identify and resolve issues that could delay provider activation or disrupt reimbursement.
• Maintain thorough documentation of enrollment activities, correspondence, and approvals in accordance with organizational policies and audit standards.
• Ensure timely revalidation and recredentialing to prevent lapses in payer participation.
• Stay current on payer enrollment guidelines, CMS regulations, and industry best practices to ensure ongoing compliance.
• This position has daily, ongoing contact with administrative staff, clinical providers and other outside contacts. This position has no direct reports.
• All other duties as assigned.

Ausbildung

Associate's degree in Business Administration or related field

Two years of credentialing experience

Two-five years of provider enrollment credentialing experience

Jobbeschreibung

National Partners in Healthcare (NPH) is seeking a Provider Enrollment Specialist for a remote role with residency requirements in AZ, TX, TN, NH, FL, or NC. The position focuses on managing enrollment and revalidation with government and commercial payers to ensure timely reimbursement.

You will work with credentialing, billing, and contracting teams to track status, resolve discrepancies, and maintain accurate provider data. Strong attention to detail and communication are essential.