Altea Healthcare ยท 4 weeks ago
Provider Enrollment Specialist
United States
Full-time
Remote
Entry, Mid Level
$26/hr - $30/hr
2+ years expAltea Healthcare is seeking a Provider Enrollment Specialist responsible for coordinating and managing the enrollment of healthcare providers into various insurance networks. The role involves ensuring that providers are properly credentialed and enrolled within payer systems to enable smooth claims processing and reimbursement.
Hospital & Health Care
Responsibilities
Complete and submit provider enrollment applications to Medicare, Medicaid, and commercial insurance carriers, ensuring accuracy and compliance with all required documentation
Assist in gathering necessary provider documentation for credentialing and re-credentialing processes with payers
Maintain and update provider enrollment records in internal systems, ensuring accuracy and timely tracking of payer updates and credentialing statuses
Serve as the primary liaison between the healthcare provider and payer networks to resolve enrollment issues, delays, or requests for additional information
Ensure that all enrollment and credentialing processes adhere to federal, state, and payer-specific regulations, with a particular focus on post-acute care
Act as the point of contact for providers and administrative staff regarding enrollment status and credentialing inquiries
Regularly follow up with payers to confirm enrollment status, address issues, and expedite the approval process
Provide management with regular updates and reports on the status of provider enrollments, ensuring transparency and timely problem resolution
Work closely with billing and revenue cycle teams to ensure providers are fully enrolled and credentialed to facilitate proper claims processing
Qualification
Required
High school diploma or equivalent; Associate's degree in healthcare administration, business, or a related field preferred
Minimum of 2-3 years of experience in provider enrollment, credentialing, or revenue cycle management within the healthcare sector
Familiarity with Medicare, Medicaid, and commercial insurance payer enrollment processes; understanding of post-acute care services and related credentialing requirements
Proficiency with provider enrollment and credentialing software systems, as well as Microsoft Office Suite (Excel, Word)
Strong ability to manage multiple tasks, prioritize, and meet deadlines in a fast-paced environment
Excellent written and verbal communication skills to interact with providers, payers, and internal teams
High attention to detail and accuracy in managing enrollment applications and ensuring compliance with payer requirements
Preferred
Experience working with Medicaid, Medicare and commercial insurance networks
Company
Altea Healthcare
ALTEA Healthcare is a leading healthcare organization committed to revolutionizing the delivery of outpatient/post-acute care.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Jodhvir Sarai MD
Chief Executive Officer
Company data provided by crunchbase