Provider Enrollment Specialist

**Role Overview**

The Provider Enrollment Specialist, under the direct supervision of the Provider Enrollment Supervisor, is responsible for maintaining participating and non‑participating provider records in the provider database, mapping claims in the invalid provider queue, and resolving provider‑related issues for claims suspended to Provider Enrollment. This role also executes the panel transfer process, completes assigned projects, and interacts with internal and external clients regarding provider maintenance activities.
Work Arrangement: Remote

**Responsibilities**

+ Communicate provider changes to appropriate providers, members, and internal departments within required timeframes.
+ Coordinate provider mailings for all claims in the invalid provider queue that cannot be processed due to missing or invalid information.
+ Research and resolve returned checks and provider mail.
+ Assist providers and internal customers by responding to and r...