Provider Enrollment Specialist

Job Description

Job Description

Position: Data Provider Enrollment Specialist

Location: Tempe, AZ

Schedule:
• Onsite Monday-Friday
• Flexible start time between 6:00am-8:00am
• 40-hour work week

Bonuses

• $7,500 sign-on bonus
• Quarterly bonus opportunity
• Free catered lunch daily
• Strong opportunity for career growth

About the Role

We are seeking a Data Provider Enrollment Specialist to join a growing healthcare team. This role is responsible for managing provider enrollment and credentialing activities for government and commercial payers to ensure accurate provider setup and timely reimbursement. The ideal candidate will have experience with provider enrollment, payer regulations, healthcare reimbursement, and clearinghouse operations.

Responsibilities

• Manage provider enrollment and revalidation processes with Medicare, Medicaid, and commercial payers
• Prepare, review, and submit provider enrollment applications and supporting documentation
• Coordinate EDI, EFT, and ERA enrollments with payers and clearinghouses
• Monitor application status and follow up with payer representatives to resolve delays or issues
• Identify and resolve enrollment-related rejections, including NPI and provider data discrepancies
• Maintain provider records, licenses, certifications, and enrollment documentation
• Utilize payer portals, online systems, and clearinghouse tools to track enrollment activity
• Partner with billing, compliance, finance, and operations teams to support reimbursement processes
• Conduct audits and maintain compliance with HIPAA and regulatory requirements
• Stay current on payer policies, enrollment requirements, and regulatory changes

Requirements

• 2+ years of provider enrollment or credentialing experience within healthcare
• Strong understanding of Medicare, Medicaid, and commercial payer enrollment processes
• Knowledge of provider enrollment documentation and application requirements
• Experience working with clearinghouse systems and resolving enrollment issues
• Familiarity with NPI numbers and provider data maintenance
• Understanding of healthcare reimbursement processes and payer regulations
• Knowledge of HIPAA, ACA, X12, ANSI, 837/835 reimbursement standards, and 270/271 claims standards
• Experience supporting EDI, EFT, and ERA enrollment activities
• Strong attention to detail, organization, and communication skills