Provider Enrollment Specialist

Provider Enrollment Specialist

As a Provider Enrollment Specialist, you will be responsible for coordinating and managing the enrollment and credentialing process for healthcare providers. Your primary goal is to ensure that providers are properly credentialed, contracted, and able to deliver services to patients. You will collaborate closely with internal departments, external agencies, and providers to facilitate timely and accurate enrollment.

A day in the life of a Provider Enrollment Specialist:

• Application Processing: Review and process enrollment applications accurately and efficiently, ensuring all information is complete and meets regulatory requirements.
• Credentialing: Ensure providers meet credentialing requirements by verifying education, training, licensure, certifications, and other qualifications.
• Provider Relations: Serve as a primary point of contact for the Provider Relations team regarding enrollment status, application requirements, and related inquiries.
• Compliance Monitoring: Monitor and track provider enrollment status and deadlines to ensure compliance with regulatory and contractual obligations.
• Database Management: Maintain accurate provider information in databases and enrollment systems, ensuring data integrity and accessibility.
• Reporting: Generate reports on provider enrollment status, trends, and issues for management review and decision-making purposes.

Knowledge, Skills, and Abilities:

• Detail-oriented and analytical mindset
• Strong problem-solving and decision-making abilities.
• Ability to maintain confidentiality and handle sensitive information.
• Customer service-oriented with strong interpersonal skills.
• Adaptability to changing priorities and requirements.

To qualify for this role, YOU MUST have:

• 4 or more years of related experience (education may be substituted in lieu of experience)
• Demonstrated experience utilizing strong organizational skills with attention to detail and accuracy
• Demonstrated experience utilizing verbal and written communication skills to inform diverse audiences of an organization
• Demonstrated ability to prioritize workload effectively, manage multiple projects concurrently, and consistently meet established deadlines
• Intermediate proficiency in MS Office Suite
• Must be able to work any 8-hour shift, Monday through Friday, 10:00 a.m. to 7:30 p.m. CST

Even BETTER if you have:

• Knowledge of healthcare regulations, payer requirements, and managed care principles.
• Bachelor's degree in Healthcare Administration, Business Administration, or a related field
• Previous experience in provider enrollment, credentialing, or healthcare administration.
• Experience with enrollment software or databases (e.g., CAQH, NPPES)

Explore a career at GDIT and you'll find endless opportunities to grow alongside colleagues who share your ambition to deliver your best work.

The likely hourly rate for this position is between $20.98 - $24.15. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.

As part of the hiring process, we will ask you to complete an identity verification process that leverages advanced biometrics and artificial intelligence to ensure authenticity and protect against identity fraud. You are expected to be on camera during virtual interviews. We reserve the right to take your picture to verify your identity and prevent fraud. By proceeding, you authorize the collection, processing, and use of your biometric data for identity verification and security purposes.

We are GDIT. A global technology and professional services company that delivers technology solutions and mission services to every major agency across the U.S. government, defense and intelligence community. Our 26,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50+ countries worldwide, offering leading mission-ready capabilities in AI, cloud, cyber and software development.

Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans