Provider Enrollment Specialist

The Aspen Group (TAG) is a large retail healthcare support organization in the U.S., supporting healthcare professionals across dental care, urgent care, and medical aesthetics. They are seeking a Provider Enrollment Specialist to manage provider enrollment and credentialing processes remotely.

Location: Remote

Salary: $24.00–$26.00 per hour

Responsibilities

• Prepare, submit and track payer enrollment applications for new providers and existing provider changes.
• Maintain accurate records of all enrollment activities in the credentialing system.
• Communicate with insurance companies, healthcare providers and internal departments to ensure applications are processed efficiently.
• Monitor enrollment status and follow up with payers to resolve delays or issues.
• Update provider demographic and practice information with all contract payers as needed.
• Ensure recredentialing timelines and requirements are maintained so providers enrollment status remains intact with no lapses.
• Work closely with Field Support, Operations, Revenue Cycle Management (RCM) team to resolve any escalated enrollment or credentialing issues in a timely manner.
• Research and resolve out of network claims issues by investigating provider participation status and effective dates of enrollment.
• Coordinate temporary provider enrollments and ensure all necessary documentation, linkage and payer updates are completed.
• Collaborate closely with RCM on status of provider enrollments including providing reports submission as needed.
• Generate and maintain enrollment status reports.
• Support audits, and other duties as assigned.

Requirements

• High school diploma or equivalent required, associate or Bachelor’s degree preferred.
• 1- 3 years of experience in payor enrollment.
• Working knowledge of commercial payors and government payor requirements.
• Proficient in Microsoft office and credentialing software including but not limited to CAQH, Availity.
• Strong attention to detail, organization and follow up skills.
• Excellent communication and customer service abilities interacting with internal teammates and external clients.
• Detail oriented, with strong level of analytical and problem-solving skills.

Benefits

• A generous benefits package that includes paid time off, health, dental, vision, and 401(k) savings plan with match.

Additional Information

• Base Pay Range: $24.00-26.00 per hour (Actual pay may vary based on experience, performance, and qualifications).
• If you are an applicant residing in California, please view our privacy policy here: https://careers.aspendental.com/us/en/tag-privacy-policy-for-california-employees