Provider Enrollment & Payer Follow-Up Specialist; Remote

Provider Enrollment & Payer Follow-Up Specialist (Remote)
(Permanent Work-From-Home | EST Shift)

About the Role

We are seeking a highly experienced  Provider Enrollment & Payer Follow-Up Specialist  who specializes in  post-submission follow-ups with payers  to ensure timely processing, approval, and activation of provider enrollment and credentialing applications.
This role is ideal for professionals with deep knowledge of  payer follow-up workflows, escalation paths, and state-specific processing requirements  across Medicare, Medicaid, Medicaid MCOs, and commercial payers. The specialist will work closely with our credentialing team to track application status, resolve deficiencies, and drive applications to completion.

Key Responsibilities
Perform  systematic follow-ups with payers  (phone, email, and portals) on submitted enrollment, credentialing, and recredentialing applications.
Track application status and identify delays, missing items, or payer-specific issues.
Communicate directly with payer representatives to obtain updates, reference numbers, and estimated turnaround times.
Escalate stalled or denied applications using payer escalation channels.
Ensure timely resolution of  deficiencies, development letters, and rework requests .
Maintain accurate tracking logs and status reports for all active applications.
Coordinate closely with the credentialing team to obtain and submit additional documentation when required.
Update and maintain provider data in CAQH, PECOS, Availity, Navinet, NPPES, and other payer portals.
Verify provider participation status and effective dates once approvals are issued.
Support follow-ups for individual, group, and facility enrollments across multiple states.
Required Experience & Skills
Minimum  3+ years of hands-on experience  in provider enrollment, credentialing, and payer follow-ups.
Strong working knowledge of  payer processing workflows  for:
Medicare
State Medicaid programs
Medicaid Managed Care Organizations (MCOs)
Commercial payers
Proven experience handling payer calls and emails independently.
Excellent understanding of enrollment lifecycle from submission to activation.
Highly organized, detail-oriented, and deadline-driven.
Strong verbal and written communication skills.
Mandatory Work-From-Home Requirements
Dedicated laptop/PC:  Intel i5 or higher, 8GB RAM , Windows 10/11 (licensed & activated)
MS Office 2013+ (working copy)
Quiet, distraction-free home office
Minimum  50 Mbps high-speed internet  (fiber or cable)
At least  1 year of prior WFH experience  during EST hours

Work Schedule:

9:00 AM – 6:00 PM EST | Monday–Friday
Compensation
Monthly Salary  (based on experience)