Provider Enrollment Specialist

Provider Enrollment Specialist

Location: Orlando, FL (On-site)

We are seeking a Provider Enrollment Specialist to manage the enrollment and reenrollment of physicians and advanced practice providers for a managed care organization. This position is a full-time, direct hire opportunity based onsite in Orlando, FL. The role prepares and submits enrollment applications to Medicare, Medicaid, and commercial health plans, maintains accurate provider data across enrollment systems, and partners with credentialing and billing teams so every provider is ready to see patients and bill from day one.

This role is well aligned for a detail oriented enrollment professional who understands how central accurate, timely enrollment is to an organization's revenue and patient experience. The ideal candidate brings a deep understanding of payer enrollment processes, follows every application through to completion with persistence, and enjoys owning each application from start to finish while working independently from the Orlando office.

Responsibilities:

• Prepare and submit provider enrollment applications to Medicare, Medicaid, and commercial health plans
• Monitor enrollment timelines and proactively follow up with payers to maintain continuous participation
• Manage provider revalidation and reenrollment cycles for CMS and state Medicaid programs
• Maintain accurate provider data in CAQH, PECOS, NPPES, and internal credentialing databases
• Research and resolve enrollment denials, rejections, and payer data discrepancies
• Coordinate with credentialing and billing teams to confirm enrollment readiness before each provider's start date
• Track and report enrollment status, turnaround times, and payer specific requirements
• Stay current with CMS enrollment regulations, state Medicaid rules, and payer participation requirements
• Process practice location additions, group reassignments, and provider demographic changes across all enrolled payers

Qualifications:

• Associate degree required; bachelor's degree in healthcare administration or business preferred
• CPCS or CPMSM certification preferred
• Minimum of 2 years of provider enrollment experience with Medicare, Medicaid, and commercial payers
• Proficiency with PECOS, NPPES, CAQH ProView, and payer enrollment portals
• Knowledge of CMS-855 forms, provider taxonomy codes, and NPI registration
• Exceptional attention to detail and the ability to manage a high volume of concurrent enrollment applications

Schedule:

• Full-time position
• Onsite in Orlando, FL
• Monday through Friday, standard business hours (Eastern Time)
• Relocation assistance may be available for qualified candidates

Salary Range: The salary range for this position is approximately $42,000 – $58,000 annually ($20.19 – $27.88 per hour), based on experience and qualifications. Relocation assistance may be available for qualified candidates.

Interview Process: Selected candidates will participate in a multi-step interview process, including an initial screening with TalentLNX followed by interviews with department leadership.

Equal Opportunity Employer: TalentLNX is committed to equal employment opportunity and a diverse, inclusive workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.