Remote Provider Enrollment & Network Specialist

Easterseals PORT; Raleigh (NC); Remote; USD 50,000 - 60,000; Full time

Job summary

Easterseals PORT Health is seeking a Provider Enrollment and Network Management Specialist to coordinate payer enrollments, site additions, and network participation. The role interfaces with Commercial, Medicare, Medicaid, and MCO payers to ensure timely implementation and maintenance of sites and services.

The position is mostly remote in North Carolina with occasional travel to NC offices; requires 3+ years in enrollment/credentialing, and strong Microsoft Office & communication skills.

Qualifications

• Associate's Degree in Healthcare Administration, Business Administration, or related field; or equivalent combination of education and experience.
• Three (3) years of experience in provider enrollment, managed care operations, credentialing support, healthcare administration, or related functions.
• Knowledge of payer enrollment and network participation processes.
• Strong organizational, project management, and problem-solving skills.
• Ability to manage multiple priorities and deadlines.
• Strong attention to detail and follow-through.
• Excellent verbal and written communication skills.
• Ability to work collaboratively across departments.
• Proficiency in Microsoft Office Suite, including Excel, Outlook, Word, SharePoint, and Teams.
• Ability to maintain confidential and sensitive information.

Responsibilities

• Coordinate and manage organizational site and service enrollments with Commercial, Medicare, Medicaid, and Managed Care Organization (MCO) payers.
• Prepare, submit, and track applications and supporting documentation required for new site, service, and program implementations.
• Monitor enrollment status and conduct follow-up with payer representatives to ensure timely processing and implementation.
• Coordinate site relocations, closures, service modifications, and organizational demographic changes with payers.
• Assist with implementation of newly executed payer contracts by coordinating site and service participation with applicable payers and communicating updates to internal stakeholders.
• Serve as the primary administrative contact for payer communications related to site and service participation.
• Maintain payer directory accuracy and coordinate resolution of directory discrepancies.
• Collaborate with Operations, Credentialing, Revenue Cycle Management, Quality Management, and program leadership regarding enrollment and implementation activities.
• Support Electronic Health Record (EHR) improvement initiatives and payer incentive programs.
• Maintain enrollment tracking logs, databases, and supporting documentation.
• Prepare reports and provide regular status updates to leadership regarding enrollment and implementation activities.
• Ensure the accuracy and completeness of enrollment records and related documentation.
• Performs other duties as assigned, including driving as required for the position.

Skills

Organizational skills

Project management

Communication skills

MS Office Suite

Attention to detail

Cross-department collaboration

Education

Associate's Degree in Healthcare Administration

Tools

Excel

Outlook

Word

SharePoint

Teams

Job description

Easterseals PORT Health is seeking a Provider Enrollment and Network Management Specialist to coordinate payer enrollments, site additions, and network participation. The role interfaces with Commercial, Medicare, Medicaid, and MCO payers to ensure timely implementation and maintenance of sites and services.

The position is mostly remote in North Carolina with occasional travel to NC offices; requires 3+ years in enrollment/credentialing, and strong Microsoft Office & communication skills.