Provider Enrollment Specialist

Job Title

Job Description Required Education: Bachelor's degree or Master's degree in Health Administration, Public Health, Healthcare Management, or a closely related field. Required Qualifications/Experience/Skills: Minimum of four (4) years of front-facing customer service experience, preferably in a healthcare, public health, health insurance, or health administration setting Experience working in a health administration environment with demonstrated knowledge of healthcare operations, processes, and client service delivery Proven ability to thoroughly document client interactions, research issues, conduct appropriate follow-up, and bring issues to resolution in a timely manner Strong problem-solving skills with the ability to analyze complex situations, identify solutions, and coordinate resolution among multiple priorities while maintaining a high level of accuracy and attention to detail Ability to work effectively in a moderately-paced environment while managing multiple tasks and maintaining a high level of accuracy and attention to detail Demonstrated ability to adapt quickly to changing procedures, priorities, and program requirements Excellent verbal and written communication skills, with the ability to communicate professionally with case managers, healthcare professionals, Client staff, vendors, and community partners Strong organizational and time-management skills Proficiency in Microsoft Office applications and experience working with databases, case management systems, or other electronic information systems simultaneously Ability to maintain confidentiality and comply with all applicable HIPAA, Client Program, and organizational requirements Preferred Qualifications: Experience supporting Client HIV/AIDS Program services, AIDS Drug Assistance Programs (ADAP), health insurance enrollment, or benefits coordination Knowledge of HIV care systems, medication access programs, and healthcare coverage options Experience providing technical assistance and support to case managers, healthcare providers, or public health partners Experience working with state or federally funded healthcare programs Overview: This position provides real-time technical assistance and customer support related to IAP enrollment and participation, while helping identify trends, resolve complex cases, and promote consistency across statewide program operations. Key Responsibilities: Program Support and Enrollment Assistance: Serve as the primary point of contact for Client case managers seeking real-time assistance with Insurance Assistance Program (IAP) enrollment, eligibility, renewals, and participation Guide program policies, procedures, documentation requirements, and enrollment processes Assist with troubleshooting enrollment barriers and resolving issues that may impact clients' access to insurance coverage and HIV medications Ensure accurate and timely communication regarding program updates, enrollment requirements, and procedural changes Client and Case Management Support: Collaborate with medical case managers throughout Tennessee to identify and resolve ADAP issues affecting HIV/AIDS clients Support efforts to remove barriers to care and medication access for eligible clients Research and resolve client-specific concerns while ensuring compliance with program guidelines and confidentiality requirements Promote a client-centered approach focused on continuity of care and access to treatment Partner Collaboration and Issue Resolution: Work closely with Client partners, vendors, and managers to resolve complex operational and client-related issues Escalate and coordinate resolution of cases requiring multi-agency or cross-functional involvement Assist in identifying systematic issues, recurring challenges, and emerging trends affecting program operations or client outcomes Provide feedback and recommendations for process improvements that enhance program efficiency and effectiveness Communication and Customer Service: Manage a high volume of incoming and outgoing telephone calls and electronic communications Maintain efficient, streamlined, and uniform communication with field case managers, Client staff, healthcare providers, and program partners Provide professional, responsive, and solution-focused customer service Document interactions, resolutions, and follow-up activities in accordance with established procedures Operational Excellence and Quality Improvement: Monitor workflows and support efforts to maintain operational excellence across the ADAP program Assist with quality assurance activities, data validation, and program monitoring initiatives Identify opportunities to improve processes, communication, and service delivery Participate in meetings, training, and collaborative workgroups to support program goals and continuous improvement efforts

**Only those lawfully authorized to work in the designated country associated with the position will be considered.**

**Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client's business needs and requirements.**