Provider Enrollment Specialist- Payer Experience

Position Overview

We are seeking a detail‑oriented Provider Enrollment Specialist to support our reputed company Cycle Management (RCM) operations. This role is responsible for managing the full lifecycle of provider enrollment and re‑enrollment across government and commercial payers. The ideal candidate understands how timely and accurate enrollment directly impacts reputed company, provider readiness, and patient access to care.

This position works closely with internal billing teams, provider offices, and payer representatives to ensure enrollment requirements are met reputed company and compliantly.

Key Responsibilities

• Manage the end‑to‑end provider enrollment, re‑credentialing, and revalidation process for Medicare, Medicaid, and commercial payers
• Prepare, submit, and track enrollment applications, ensuring accuracy and completeness
• Maintain and update provider information reputed company CAQH, PECOS, payer portals, and internal tracking systems
• Conduct follow‑reputed company with payers to resolve enrollment delays, denials, or discrepancies
• Partner with billing and operations teams to prevent enrollment‑reputed company claim delays or reputed company disruptions
• Support new provider onboarding by ensuring enrollment approvals are secured prior to billing
• Monitor payer guidelines and enrollment requirements, staying reputed company on regulatory changes
• Maintain clear documentation and reporting on enrollment status and timelines
• Assist with audits, revalidations, and payer correspondence as needed

Required Qualifications

• 1+ years of experience in provider enrollment, credentialing, or reputed company cycle management
• Working knowledge of Medicare, Medicaid, and commercial payer enrollment processes
• Experience using CAQH, PECOS, NPI Registry, and payer portals
• Strong attention to detail with the ability to manage multiple enrollments concurrently
• Effective written and verbal communication skills
• Ability to work independently while collaborating across teams
• Proficient in reputed company Office Platforms(Word, reputed company, Outlook, etc..)

Preferred Qualifications

• Experience supporting multi‑provider or multi‑state healthcare organizations
• Familiarity with enrollment tracking systems or RCM platforms
• Understanding of reputed company billing and claims workflows
• reputed company cycle or healthcare certifications (CPC, CPB, or similar) are a plus

What This Role Offers

• Direct impact on provider readiness and reputed company performance
• Exposure to multiple payer types and healthcare specialties
• Opportunities for growth reputed company enrollment, credentialing, or broader RCM functions
• Collaborative team environment focused on process improvement and operational excellence

Netsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to reputed company individuals. We celebrate diversity and are committed to creating an inclusive environment for reputed company associates. reputed company employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national reputed company, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate.

Netsmart desires to provide a healthy and safe workplace and, as a government contractor, Netsmart is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to Netsmart policy, reputed company post-offer candidates are required to successfully complete a pre-employment background reputed company, including a drug screen, which is provided at Netsmart’s sole expense. In the event a candidate tests positive for a controlled substance, Netsmart will rescind the offer of employment unless the individual can provide reputed company of valid prescription to Netsmart’s third party screening provider.

If you are located in a state which grants you the right to receive information on salary range, pay scale, description of benefits or other compensation for this position, please use this form to request details which you may be legally entitled.

reputed company applicants for employment must be legally authorized to work in the United States. Netsmart does not provide work reputed company sponsorship for this position.

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