Provider Enrollment Specialist

JOB SUMMARY:

The position is responsible for providing support to the operations of the Provider Network, Managed Care, and the Medical Affairs Departments. This role supports daily operations of provider enrollment, contracting, and ongoing administrative tasks. Reporting to the Executive Director of the Provider Network, this position will be working alongside the network credentialing manager to provide support for credentialing efforts and complete administrative support duties to Medical Affairs.

DUTIES AND RESPONSIBILITIES:

• Support physician, advanced practice provider and facility credentialing.
• Oversee follow up and documentation of credentialing and re-credentialing.
• Aid in the provider contracting processes, call schedules, compensation metrics, and medical directorship workflows in collaboration with legal, HR, and physician services leadership in support of the Medical Affairs office.
• Serve as a liaison to medical staff, ensuring timely communication, and issue resolution.
• Complete documentation as needed for credentialing and contracting, including but not limited to documentation in: Excel, Word, Teams Channels.
• Promote a culture of safety, quality, and patient-centered care while ensuring compliance with organizational, state, and federal requirements.
• Support service delivery through resource planning, scheduling oversight, operational problem-solving, and ensuring access to high-quality care.
• Perform additional responsibilities as needed to support departmental and organizational goals.

EDUCATION AND RELATED EXPERIENCE:

Required:

• High school diploma or equivalent experience.
• Three years’ experience in payer enrollment, credentialing, administrative work in a healthcare environment.

Preferred:

• Bachelor’s Degree Preferred (preferred fields of Business, Healthcare Administration).