Provider Enrollment Specialist

Provider Enrollment Specialist

American Advanced Management is seeking a Provider Enrollment Specialist to manage the administrative process of credentialing healthcare providers with insurance companies and government payers like Medicare and Medicaid.

• Prepare and submit enrollment applications and supporting documents for new and existing providers.
• Maintain and update provider information in databases and systems, ensuring accuracy of details such as licenses, certifications, and addresses.
• Verify provider credentials and ensure all paperwork meets the requirements of various health plans and government payers.
• Act as a liaison by responding to inquiries from providers and payers and follow up to expedite the enrollment and re‑enrollment process.
• Research and resolve issues that delay enrollment, such as missing information on applications.
• Organize and maintain files for all provider enrollments and other related documentation.

Requirements: a strong understanding of healthcare regulations, payer requirements, and provider enrollment processes; familiarity with medical terminology and basic billing practices; technical proficiency with provider enrollment software, credentialing databases such as CAQH, and common office applications like Word and Excel; excellent attention to detail, strong organizational skills, and effective communication; 3‑5 years of experience in a healthcare setting, preferably in credentialing, managed care, or claims processing.

Salary: $22.00 – $26.00 per hour.

Location:

Stockton, CA. Salary range: $58,900.00–$72,800.00 (full‑time, mid‑senior level). Final date to receive applications: 2 weeks ago.