Provider Enrollment Specialist (Medicaid)

Location: Remote within the United States; listed location is Franklin, Tennessee

Company

Healthcare revenue cycle management provider delivering specialty claims, denials, and reimbursement solutions through an intelligent automation platform and expert operational support.

What you will do

• Collect, verify, and submit online and paper enrollment applications for hospitals and physicians with Out-of-State Medicaid payers.
• Manage re-enrollment applications and maintain current provider enrollment status.
• Develop and maintain state-specific Medicaid enrollment policies, procedures, and requirements.
• Manage work queues and deadlines for payer forms, license updates, deficiency notifications, approval letters, and related documents.
• Maintain accurate provider files and document provider changes, corrections, and terminations in the database.
• Communicate enrollment requirements and regulatory updates to internal operations stakeholders.

Requirements

• High school diploma or GED required; an associate or bachelor’s degree is preferred.
• At least 1 year of healthcare experience in billing or collections.
• At least 1 year of client-facing or customer service experience.
• Intermediate understanding of insurance payer and provider claims processing and related data requirements.
• Knowledge of provider enrollment requirements, application documentation, credentials, and licenses such as hospital licenses, CLIA, DEA, NPI, and board certifications.
• Strong computer, communication, analytical, problem-solving, prioritization, and independent-working skills, including proficiency with Microsoft Word, Excel, and Outlook.

Culture & Benefits

• Remote work environment with regular and predictable attendance expectations.
• Focus on professional growth, development, and employee support.
• Culture emphasizing cooperation, shared goals, flexibility, and work-life balance.
• Equal opportunity workplace committed to an environment free from discrimination and harassment.