Provider Enrollment Specialist

About the role

Raventra Health is seeking a Provider Enrollment Specialist to manage payer enrollment activities for provider clients, ensuring proper enrollment with Medicare, Medicaid, and commercial insurance plans.

Key responsibilities

• Prepare and submit provider enrollment applications to Medicare, Medicaid, and commercial payers
• Gather and review provider information and supporting documentation required for enrollment
• Track enrollment applications, payer requests, approvals, and effective dates
• Follow up with payers and enrollment organizations on pending or delayed applications
• Research and resolve enrollment discrepancies, rejections, and missing information
• Maintain accurate provider and payer enrollment records in internal systems and online portals
• Process updates to provider information, including practice locations, specialties, and affiliations
• Coordinate enrollment-related information with credentialing, billing, and client teams
• Monitor enrollment deadlines and support timely revalidation, renewals, and payer updates

Required profile

• 1+ year of experience in provider enrollment, payer enrollment, credentialing, medical billing, or a related healthcare administrative role
• Understanding of Medicare, Medicaid, and commercial payer enrollment processes
• Experience preparing and submitting enrollment applications and supporting documentation
• Familiarity with payer portals and online provider enrollment systems
• Strong attention to detail and ability to manage multiple applications and deadlines
• Strong organizational and follow‑up skills
• Ability to research enrollment issues and communicate effectively with payers and provider teams
• Ability to work independently and effectively in a fully remote environment
• HIPAA‑compliant private workspace

Required skills

• Knowledge of NPI, taxonomy codes, PECOS
• Experience with CAQH
• Familiarity with Epic, Athena, eClinicalWorks