provider Enrollment specialist

Hyderabad - India

Monthly Salary: Not Disclosed

Posted on: 6 hours ago

Vacancies: 1 Vacancy

Job Summary

Key Responsibilities

1. Payer Follow-ups (Mandatory PE Follow-up Expertise)

Conduct timely follow-ups with payers via phone and email to obtain status updates on submitted enrollment applications.
Manage follow-up workflows for new enrollments revalidations demographic updates terminations and group affiliations.
Understand payer-specific processes documentation needs and follow-up cycles.

2. Communication & Professional Interaction

Use professional phone etiquette while engaging with payer representatives provider relations teams and enrollment departments.
Draft clear concise and accurate emails for information requests escalations and status tracking.
Maintain a high standard of communication while representing the organization and providers.

3. Issue Identification & Resolution

Identify missing documents payer clarifications or discrepancies delaying enrollment.
Flag high-priority cases and coordinate with internal teams (Enrollment Analysts Credentialing Specialists) to resolve blockers.
Document outcomes of all calls/emails and update systems in real time.

4. Documentation & Tracking

Update CRM/workflow tools payer portals and internal trackers with accurate follow-up details.
Ensure all communication and actions meet audit compliance and HIPAA standards.
Track pending applications and follow set timelines to avoid backlogs.

5. Workflow & Productivity Management

Manage daily call queues turnaround expectations and follow-up SLAs.
Prioritize urgent and high-value applications based on team guidance and SLO/TAT needs.
Participate in team huddles refresher trainings and process updates.

Required Qualifications

Mandatory:
- Proven experience in Provider Enrollment Follow-up (minimum 1 2 years preferred).
- Strong verbal and written communication skills and confident phone presence.
- Willingness and ability to work exclusively from office (Hyderabad WFO).
Good understanding of payer enrollment processes NPI CAQH and payer portal navigation.
Ability to handle high-volume follow-up queues with accuracy and professionalism.
Experience working in a metric-driven environment.

Preferred Skills

Experience in healthcare operations credentialing AR/RCM or payer interaction roles.
Familiarity with CRM or workflow tools used for provider enrollment.
Strong documentation discipline and attention to detail.

Key Responsibilities 1. Payer Follow-ups (Mandatory PE Follow-up Expertise) Conduct timely follow-ups with payers via phone and email to obtain status updates on submitted enrollment applications. Manage follow-up workflows for new enrollments revalidations demographic updates terminations and...