Payor Audit & Enrollment Specialist
Listed on 2026-09-12
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Business
Financial Compliance
The Specialist – Payor Audit & Provider Enrollment serves as the organization’s subject-matter expert for payor audit
response, delegated credentialing oversight, and provider enrollment data integrity. This role manages payor-initiated audits
from intake through resolution, determining response strategy and authoring formal responses on behalf of the organization;
leads delegated credentialing audits and maintains continuous audit readiness against payor and accreditation standards;
and governs provider enrollment and billing data within Dental Xchange and connected systems. Working under general
direction, the Specialist interprets payor contracts, delegation agreements, and regulatory requirements, exercises
independent judgment in assessing and escalating compliance and revenue risk, and develops the policies, controls, and
reporting that govern these functions. The position advises Credentialing, Compliance, and Revenue Cycle leadership,
partners across practice operations and billing, and provides technical guidance and mentorship to credentialing and
enrollment staff.
- Medical insurance
- Dental services
- Life insurance
- Vision insurance
- Long term disability
- Section 125 - Flexible Spending Account
- 401K
- EAP program
- DCA voluntary supplemental insurance products
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