
Provider Enrollment Specialist
Required skills
- Provider Enrollment
- Credentialing
- Payor Credentialing
- Managed Care
- Medicare
- Medicaid
- Workers Compensation
- CAQH
- CAQH Practice Administrator
- Multi-Tax ID entities
Nice to have
- Health plan relationships
- Process automation
- Workflow optimization
Role summary
Seeking a motivated and autonomous Provider Enrollment Specialist for a Managed Care Operations team. This remote role involves accurate data entry of demographic and financial information, researching and resolving complex issues, and managing work queues to ensure timely and accurate enrollment and billing processes. The specialist will handle high-volume credentialing and recredentialing applications for various payor types, adhering to turnaround times and performance metrics. Requires strong organizational, communication, and interpersonal skills, with proficiency in MS Office Suite.
We are seeking a credentialing candidate that is a highly motivated, autonomous individual who has a positive attitude to join our company as a Provider Enrollment Specialist on the Managed Care Operations team.
The enrollment specialist ensures that all data entry is accurate, including demographic and financial information for each account. Responsible for researching complex problems using available resources and implementing solutions to mitigate any future issues. This job will be responsible for working various work queues and other duties as assigned. The responsibilities will be aligned with the timely and accurate entry of all phases of enrollment/billing process for exceptional level of service to our members. This job requires professional behavior, dependability and good communication skills.
Qualified candidates must possess:
- Minimum of 3-5 years’ experience submitting payor credentialing applications for providers
- Health plan knowledge and familiarity required credentialing all payor types: Managed Care, Medicare & Medicaid Replacements & Workers Compensation
- Experience utilizing & maintaining credentialing database
- Highly knowledgeable & proficient with CAQH database. Familiarity with CAQH Practice Administrator role.
- Have established relationships with credentialing reps at various health plans
- Prepare and process credentialing applications for all payor types
- Experience credentialing multi-Tax ID entities
- Comfortable processing high volume credentialing applications & recredentialing applications
- Meet and adhere to company’s turnaround time and comply with credentialing goals and performance metrics
- Customer service oriented & easily able to develop relationships.
- Will have a detail-oriented and motivated work ethic, as well as capable of managing projects in a timely manner to meet set deadlines
- Possess excellent organizational, interpersonal, and communication skills
MS Word, Excel & Access skills required
Work Environment
- The role follows a remote work schedule central hours.
- Must be able to work in a fast-paced environment and manage multiple tasks with minimal supervision.
What You’ll Get:
- Comprehensive great inexpensive benefits.
- Generous paid time off with holidays.
- Continuous mentoring to further your career path.
- Great close-knit team environment. We work hard, but we have fun!
USPh (U.S. Physical Therapy) is one of the largest publicly traded, independent operators of leading physical and occupational therapy clinics dedicated to enhancing patient outcomes through a collaborative, partnership-driven model. We partner with close to 700 clinics nationwide, across 44 states, offering them the resources, operational support, and clinical expertise needed to thrive in today’s healthcare landscape.
By aligning with the USPh network, our partners benefit from operational support and a shared commitment to evidence-based care, all while maintaining their autonomy and local identity.
We believe that the strength of our partnerships lies in the individuality of each partner. Our “OnePartner” model is designed to allow clinics to maintain their unique culture and identity, empowering them to foster meaningful relationships within their communities. By preserving their local roots, clinics can continue to build trust with patients and referral sources, while attracting top talent who value the chance to be part of a personalized, community-centered environment.
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