Provider Enrollment Specialist

Job Description

Job Description

Job Title : Provider Enrollment Specialist

Location : Buffalo, NY

Hire Type : Temporary

Pay Range : $25.00-27.00/hour

Work Type : Full-time

Work Model : Onsite

Work Schedule : Monday – Friday, 8:30am – 4:30pm

Recruiter Contact: Amy Dugenske | View phone number on ziprecruiter.com |View email address on ziprecruiter.com

Nature & Scope :

Positional Overview

The Imagine Group is recruiting for a Provider Enrollment Specialist on behalf of our client, a leading behavioral health and human services organization in Buffalo, NY , dedicated to providing comprehensive mental health, substance use, rehabilitation, and supportive services to individuals and families throughout Western New York. With a strong focus on community impact, compassionate care, and person-centered support, the organization is committed to helping individuals achieve improved health, stability, and overall well-being.

In this role you will be responsible for coordinating and processing provider enrollment, credentialing, and recredentialing applications with insurance carriers, government payers, and regulatory agencies. You will maintain accurate provider records, monitor enrollment status and compliance requirements, and collaborate with internal departments to ensure timely approvals and uninterrupted provider participation with payers.

Role & Responsibility:

Tasks That Will Lead to Your Success

• Maintain updated knowledge of Provider Enrollment regulations and develop new/update existing procedure documentation.
• Collaborate with insurance carriers to ensure the team is enrolling in new programs by following the applicable requirements and enrollment procedures.
• Investigate new external electronic platforms used by insurance carriers and ensure the team is prepared to utilize them efficiently and effectively.
• Receive and analyze all verified documentation for Providers and execute provider enrollment with carriers.
• Process new enrollments, revalidations, and making sure all providers are linked with their appropriate sites.
• Shares essential updates with providers and internal teams as necessary in weekly summary reports or other correspondence.
• Collaborate with the Billing team on enrollment issues to investigate and correct.
• Work closely and effectively with the Insurance Carriers and Providers.
• Correspond with providers and Program Directors as necessary.
• Establish a relationship with the carrier credentialing representative and keep up on any changes or updates with the carriers.
• Communicate with providers on any enrollment issues, needs and updates.
• Update Providers CAQH accounts.

Skills & Experience

Qualifications That Will Help You Thrive

• Hands-on experience in provider enrollment is required
• Familiarity with CAQH and insurance carrier processes
• Strong communication skills — you'll be interfacing with carriers, providers, and internal teams regularly
• Someone who's organized, proactive, and comfortable building processes, not just following them
• HR or internal customer service experience is a plus but not required