Provider Enrollment Specialist

Provider Enrollment Specialist
Location: Irving, TX | Onsite

COMPENSATION & SCHEDULE
• $24.45/hour – $26.19/hour
• Monday–Friday | Full Time
• Temp-to-Hire | W2

ROLE IMPACT
The Provider Enrollment Specialist ensures providers are properly enrolled, credentialed, and maintained with Medicare, Medicaid, and managed care payers to support accurate billing and timely reimbursement. This role directly impacts revenue cycle performance by reducing claim denials, resolving enrollment issues, and maintaining compliant provider records. Success is measured by clean enrollments, reduced outstanding claims, and effective coordination between payers, billing vendors, and clinic teams.

Responsibilities

• Coordinate Medicare and Medicaid provider enrollment and re-enrollment activities
• Prepare, submit, and track provider enrollment applications and updates with commercial and government insurance carriers
• Maintain provider identification numbers, National Provider Identifier (NPI) records, and credentialing documentation
• Follow up with payers regarding application approvals, claim status, and reimbursement issues
• Review and resolve outstanding claims, appeals, denials, and non-payment discrepancies
• Generate reports for enrollment tracking and reimbursement reconciliation
• Support managed care contract reviews and verify billing and payment accuracy
• Assist with billing system inquiries and updates, including Athena (athenahealth) correspondence and resolution of unpostable transactions
• Educate staff on billing corrections and front-end data entry best practices
• Maintain compliance with HIPAA (Health Insurance Portability and Accountability Act) and confidentiality standards
• Communicate effectively with internal departments, providers, patients, and insurance payers

Minimum Qualifications
• High School Diploma required (proof of education required at submission)
• 1–3 years of healthcare payer enrollment, provider credentialing, and medical billing experience
• Proficiency in Microsoft Word, Excel, and Access with strong organizational and communication skills

Core Tools & Systems
• Medicare and Medicaid enrollment portals
• Managed care and commercial insurance carrier systems
• Athena (athenahealth) practice management and billing platform
• Microsoft Word, Excel, and Access
• Claims processing and reimbursement tracking systems

Preferred Skills
• Experience supporting multi-provider or multi-location healthcare practices
• Familiarity with appeals management and denial resolution workflows
• Strong analytical skills for enrollment tracking and revenue cycle reporting

Legal Notice
This position requires a 30-mile residency radius from Irving, TX. The application process includes an in-person interview, criminal background check, education and employment verification, drug screen, and clerical skills testing as part of pre-employment requirements.

By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from CornerStone and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy at: https://www.cornerstonestaffing.com/privacy