Provider Enrollment Specialist
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Monthly Salary:
Posted on:
8 hours ago
Vacancies:
1 Vacancy
Job Summary
Job Description: Provider Enrollment Follow-up Specialist (PE Follow-up) Role Title: Provider Enrollment Follow-up Specialist
Department: Provider Operations
Location: Chennai Work From Office (WFO only)
Experience Required: 1 3 years in healthcare voice processes (Provider Enrollment preferred but AR/RCM/Healthcare Voice also acceptable)
Mission of the Role
To ensure timely and accurate follow-up with payers for provider enrollment applications by using professional phone and email communication resolving pending issues and supporting the enrollment lifecycle through high-quality interactions.
Key Responsibilities
1. Payer Follow-ups & Communication
Make outbound calls and send professional emails to payers enrollment departments
and provider relations teams to check the status of submitted applications.
Document all communication accurately and update status trackers/CRM systems in real
time.
Maintain strong phone/email etiquette to represent the provider and the organization
professionally.
2. Enrollment Status Management
Track all submitted applications-new enrollment revalidation demographic updates
and terminations.
Identify missing information additional documentation requirements or payer-specific
clarifications.
Escalate urgent or stuck applications to the Senior Analyst/Team Lead.
3. Issue Identification & Resolution
Research and troubleshoot issues such as incorrect provider data incomplete
documentation NPI/taxonomy mismatches or portal discrepancies.
Coordinate with internal teams (Enrollment Credentialing Data Management) to resolve
blockers and re-submit required information.
Ensure timely follow-up cycles to avoid processing delays.
4. Compliance & Documentation
Adhere to payer-specific guidelines call handling standards and documentation norms.
Ensure all communication follow-ups and payer responses are captured accurately for
audit and compliance purposes.
Follow HIPAA and internal confidentiality standards.
5. Workflow & Productivity Management
Work efficiently through daily call queues and email follow-up tasks.
Prioritize escalations and time-sensitive cases based on SLO/TAT expectations.
Participate in huddles training sessions and process updates as required.
Required Qualifications
Experience in Provider Enrollment OR Healthcare Voice Processes
such as AR calling RCM calling prior authorization or patient services.
Strong phone etiquette email writing skills and clarity in communication.
Ability to handle payer conversations confidently and professionally.
Basic understanding of healthcare provider types NPI CAQH and payer enrollment
workflows (preferred but not mandatory).
Comfortable working in a fast-paced metric-driven operational environment.
Preferred Skills
Experience using payer portals CRM tools or workflow management systems.
Exposure to provide credentialing or healthcare operations.
Ability to identify issues and communicate them effectively to senior team members.
Work Environment & Expectations
Work From Office Hyderabad (mandatory).
Requires strong discipline in documentation follow-up cycles and adherence to
communication standards.
Willingness to work aligned to U.S. payer hours as required.
--Department: Provider Operations
Location: Chennai Work From Office (WFO only)
Experience Required: 1 3 years in healthcare voice processes (Provider Enrollment preferred but AR/RCM/Healthcare Voice also acceptable)
Mission of the Role
To ensure timely and accurate follow-up with payers for provider enrollment applications by using professional phone and email communication resolving pending issues and supporting the enrollment lifecycle through high-quality interactions.
Key Responsibilities
1. Payer Follow-ups & Communication
Make outbound calls and send professional emails to payers enrollment departments
and provider relations teams to check the status of submitted applications.
Document all communication accurately and update status trackers/CRM systems in real
time.
Maintain strong phone/email etiquette to represent the provider and the organization
professionally.
2. Enrollment Status Management
Track all submitted applications-new enrollment revalidation demographic updates
and terminations.
Identify missing information additional documentation requirements or payer-specific
clarifications.
Escalate urgent or stuck applications to the Senior Analyst/Team Lead.
3. Issue Identification & Resolution
Research and troubleshoot issues such as incorrect provider data incomplete
documentation NPI/taxonomy mismatches or portal discrepancies.
Coordinate with internal teams (Enrollment Credentialing Data Management) to resolve
blockers and re-submit required information.
Ensure timely follow-up cycles to avoid processing delays.
4. Compliance & Documentation
Adhere to payer-specific guidelines call handling standards and documentation norms.
Ensure all communication follow-ups and payer responses are captured accurately for
audit and compliance purposes.
Follow HIPAA and internal confidentiality standards.
5. Workflow & Productivity Management
Work efficiently through daily call queues and email follow-up tasks.
Prioritize escalations and time-sensitive cases based on SLO/TAT expectations.
Participate in huddles training sessions and process updates as required.
Required Qualifications
Experience in Provider Enrollment OR Healthcare Voice Processes
such as AR calling RCM calling prior authorization or patient services.
Strong phone etiquette email writing skills and clarity in communication.
Ability to handle payer conversations confidently and professionally.
Basic understanding of healthcare provider types NPI CAQH and payer enrollment
workflows (preferred but not mandatory).
Comfortable working in a fast-paced metric-driven operational environment.
Preferred Skills
Experience using payer portals CRM tools or workflow management systems.
Exposure to provide credentialing or healthcare operations.
Ability to identify issues and communicate them effectively to senior team members.
Work Environment & Expectations
Work From Office Hyderabad (mandatory).
Requires strong discipline in documentation follow-up cycles and adherence to
communication standards.
Willingness to work aligned to U.S. payer hours as required.
Key Skills
- Sales Experience
- Crane
- Customer Service
- Communication skills
- Heavy Equipment Operation
- Microsoft Word
- Case Management
- OSHA
- Team Management
- Catheterization
- Microsoft Outlook Calendar
- EHS
