Provider Enrollment Quality Specialist

A company is looking for a Provider Enrollment Quality Professional.

Key Responsibilities

Conduct quality reviews of provider enrollment applications, maintenance, and renewals to ensure compliance and accuracy

Monitor team performance and documentation standards, identifying opportunities for process improvement

Collaborate with enrollment leadership and staff to share quality findings and recommend corrective actions

Required Qualifications

3+ years of experience in provider enrollment, credentialing, healthcare operations, or quality assurance

Working knowledge of Medicaid or Medicare provider enrollment processes, regulations, and payer requirements

Experience with enrollment systems such as PECOS, CAQH, or similar tools

Proficiency with Microsoft Office applications and reporting tools

Demonstrated ability to multitask, work independently, and adapt to process or regulatory changes