PROVIDER ENROLLMENT SPECIALIST

PROVIDER ENROLLMENT SPECIALIST

Irving, TX | Onsite

COMPENSATION & SCHEDULE

• $24.45–$26.19 per hour

• Monday–Friday, 8:00 AM–5:00 PM

• Full-time, W2

• Start Date: April 13, 2026

ROLE IMPACT

The Provider Enrollment Specialist ensures healthcare providers are properly enrolled and credentialed with Medicare, Medicaid, and managed care organizations to enable compliant and timely reimbursement. This role supports billing system administration, provider data management, and payer communication to maintain continuity of billing operations and cash flow. Success is defined by accurate enrollment processing, regulatory compliance, and excellent service to internal teams and external payers.

KEY RESPONSIBILITIES

• Collect, prepare, and maintain accurate provider data for Medicare and Medicaid enrollment and updates

• Submit, monitor, and follow up on payer applications, ensuring compliance with federal and state enrollment standards

• Request and maintain NPI numbers for providers and clinics

• Communicate claim and enrollment information to internal teams and external partners

• Assist with billing system user support, training, and problem resolution as a designated superuser

• Analyze and resolve problem accounts and payer rejections related to provider setup or credentialing

• Maintain confidentiality and ensure compliance with HIPAA and organizational guidelines

MINIMUM QUALIFICATIONS

• High School Diploma required

• 1–3 years of provider enrollment or provider credentialing

• Proficiency in Microsoft Word, Excel, and Access

• Strong written and verbal communication skills

• Excellent organizational and team collaboration abilities

• Must live within a 30-mile radius of Irving, TX

CORE TOOLS & SYSTEMS

• Microsoft Office Suite (Word, Excel, Access)

• Medicare PECOS, Medicaid, and NPPES systems

• Managed Care Portals

• Healthcare billing and credentialing software

PREFERRED SKILLS

• Experience with managed care contracting and billing processes

• Knowledge of payer enrollment compliance and reimbursement workflows

• Ability to lead system training or process improvement initiatives

PRE-EMPLOYMENT REQUIREMENTS

• In-person interview

• Background check (criminal, education, employment verification)

• Drug screen

• Clerical testing

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