Provider Enrollment Specialist

Join a team that’s transforming mental healthcare. Founded by psychiatrists, Headlight is more than a company: it’s a movement. A movement that exists on the front lines of the mental health crisis, transforming the way people access care and the way clinicians deliver it. In order to help people in their time of need and ensure that every person who comes to us has options, we are transparent about our capabilities, treatments, and coverage, we champion innovation, and we leverage our rich data to continuously implement better ways of delivering care. Our mission is simple but powerful: Improving lives, one session at a time. Our highly skilled and principled clinical team enjoys autonomy and institutional support so they can put their focus where it should be: on improving patient outcomes. Our clinicians want to do more than help individual clients, so they work to affect the system as a whole, elevating standards of care so that their efforts reverberate far beyond what they could do in private practice. As the most trusted behavioral health partner in the Western U.S., we’ve established deep relationships that give us unparalleled access, interoperability, and first-priority referrals. This exclusivity, combined with our best‑in‑class coordinated care and feedback loops, results in superior outcomes and cost savings. Our services are convenient, accessible, and expert, combining personalized client engagement with advanced technology to enhance, not replace, human connection. Indeed, we hold that human‑to‑human relationships are indispensable, so from the match to the session to the time between sessions, we provide whole person care so nobody falls through the cracks and there is a brighter path forward for all. The Provider Enrollment Specialist is responsible for enrolling, maintaining provider records within Headlight Health and its contracted Health Plan payors to ensure accurate participation status, claims payment, and provider directory integrity. This role coordinates with internal departments, providers, delegated entities, and external payers/regulators to support timely, compliant provider onboarding and ongoing maintenance. Our Pillars Make things easier Forge genuine connections Elevate the standard Roles And Responsibilities Process provider and facility enrollments, updates, and terminations across commercial, Medicare, and/or Medicaid lines of business in accordance with health plan policies and regulatory requirements. Validate completeness and accuracy of enrollment submissions (e.g., demographic data, tax information, NPIs, licensure, specialties, practice locations). Submit and track enrollment requests with delegated groups and external entities as applicable; follow up to resolution. Partner with Credentialing, Payor Relations and Billing to ensure aligned provider participation, effective dates, and correct network assignments. Support provider onboarding activities by coordinating required documents and resolving discrepancies between credentialing and enrollment data. Maintain accurate provider data in enrollment and claims systems, ensuring correct affiliations, TIN/NPI combinations, service locations, taxonomy codes, and pay-to/remit-to addresses. Perform quality checks to prevent downstream claim denials and directory inaccuracies. Document actions thoroughly in tracking tools and case management systems. Ensure enrollment actions support compliance with CMS/state requirements, including directory accuracy and timely updates. Assist with audits and compliance requests by providing documentation, reports, and status updates. Follow established controls for PHI/PII handling and data security. Respond to provider/practice inquiries regarding enrollment status, effective dates, required documentation, and next steps. Research and resolve enrollment‑related problems, including duplicate records, conflicting affiliations, or missing/invalid identifiers. Meet productivity and turnaround time standards while maintaining accuracy. Identify process gaps and recommend improvements (templates, checklists, workflows) to reduce cycle time and rework. Required Qualifications High school diploma or GED required; Associate’s or Bachelor’s degree preferred. 1-3+ years of experience in provider enrollment, provider data management, credentialing support, or healthcare administration (health plan experience preferred). Working knowledge of provider identifiers and enrollment data elements, including NPI, TIN, taxonomy, licensure, specialties, and practice locations. Familiarity with provider lifecycle processes: onboarding, maintenance, terminations, and effective date management. Proficiency with Microsoft Office (Excel, Outlook, Word) and comfort working in multiple systems and portals. Strong attention to detail, organizational skills, and ability to manage multiple cases with competing deadlines. Preferred Qualifications Certified Provider Enrollment Specialist (CPES) or Certified Provider Credentialing Specialist (CPCS) Experience with Medicare and/or Medicaid enrollment requirements and/or CMS provider directory standards. Understanding of NCQA Accreditation Standards Experience using provider data/enrollment platforms and ticketing tools (e.g., Modio, HubSpot). Understanding of delegated credentialing/enrollment and network contracting workflows. Lean/Six Sigma exposure or process improvement experience. Benefits W2 role with competitive hourly rate Medical, Dental and Vision on the first of the month after employment (based on FT hours) Paid Vacation, Sick, and Holiday time Employee Assistance Program (EAP) provides confidential counseling services, resources, and support to help you navigate personal or professional challenges. 401(k) plan with company contribution Remote work schedule Opportunity to work in a cutting‑edge healthcare technology environment Professional development opportunities and training Collaborative and supportive work culture Impactful role contributing to the enhancement of patient care and healthcare processes If you need any accommodations for your interview please email View email address on click.appcast.io prior to scheduling. Not meeting all the requirements? Research indicates that women, communities of color, and historically underrepresented individuals are often hesitant to apply for jobs unless they meet every qualification. We are committed to cultivating a diverse, inclusive, and genuine workplace. If you’re enthusiastic about this position but your previous experience doesn’t precisely match every qualification listed, we enthusiastically encourage you to submit your application. You could be the ideal candidate for this role or others! Headlight is committed to the principles of diversity, equity, and inclusiveness and seeks to create a working environment reflective of this commitment. We seek to provide a diverse clinician base to support the diversity of our clients. Headlight supports and respects diversity of people, culture, and ideas throughout our organization. Headlight thrives to be a welcoming, diverse and discrimination‑and harassment‑free workplace. By applying for this position, you consent to receive future communications from Headlight via email or text regarding this application and related employment opportunities. You may opt‑out at anytime by contacting us directly. Job Postings on Indeed and other job boards may post with total compensation (base + bonus). For the exact base salary range please check our website or our job‑site. We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us. #J-18808-Ljbffr