Provider Enrollment Specialist

Posted 16 Days Ago
Be an Early Applicant
Houston, TX, USA
In-Office
58K-63K Annually
Mid level
Fitness • Healthtech
The Role
Processes provider credentialing and enrollment applications across managed care, Medicare, Medicaid, and workers compensation payors. Maintains accurate provider demographic and financial data, manages credentialing databases and work queues, researches complex issues, coordinates with health plan representatives, and supports timely billing and enrollment workflows. The role requires high-volume application processing, CAQH expertise, deadline management, strong communication, and independent work in a remote environment.
Summary Generated by Built In
Company Description

USPh (U.S. Physical Therapy) is one of the largest publicly traded, independent operators of leading physical and occupational therapy clinics dedicated to enhancing patient outcomes through a collaborative, partnership-driven model. We partner with close to 700 clinics nationwide, across 44 states, offering them the resources, operational support, and clinical expertise needed to thrive in today’s healthcare landscape.

By aligning with the USPh network, our partners benefit from operational support and a shared commitment to evidence-based care, all while maintaining their autonomy and local identity.  

We believe that the strength of our partnerships lies in the individuality of each partner. Our “OnePartner” model is designed to allow clinics to maintain their unique culture and identity, empowering them to foster meaningful relationships within their communities. By preserving their local roots, clinics can continue to build trust with patients and referral sources, while attracting top talent who value the chance to be part of a personalized, community-centered environment.

Job Description

 

We are seeking a credentialing candidate that is a highly motivated, autonomous individual who has a positive attitude to join our company as a Provider Enrollment Specialist on the Managed Care Operations team.

The enrollment specialist ensures that all data entry is accurate, including demographic and financial information for each account. Responsible for researching complex problems using available resources and implementing solutions to mitigate any future issues. This job will be responsible for working various work queues and other duties as assigned. The responsibilities will be aligned with the timely and accurate entry of all phases of enrollment/billing process for exceptional level of service to our members. This job requires professional behavior, dependability and good communication skills.

 

 

Qualifications

Qualified candidates must possess:

  • Minimum of 3-5 years’ experience submitting payor credentialing applications for providers
  • Health plan knowledge and familiarity required credentialing all payor types:  Managed Care, Medicare & Medicaid Replacements & Workers Compensation
  • Experience utilizing & maintaining credentialing database
  • Highly knowledgeable & proficient with CAQH database. Familiarity with CAQH Practice Administrator role.
  • Have established relationships with credentialing reps at various health plans
  • Prepare and process credentialing applications for all payor types
  • Experience credentialing multi-Tax ID entities
  • Comfortable processing high volume credentialing applications & recredentialing applications
  • Meet and adhere to company’s turnaround time and comply with credentialing goals and performance metrics
  • Customer service oriented & easily able to develop relationships.
  • Will have a detail-oriented and motivated work ethic, as well as capable of managing projects in a timely manner to meet set deadlines
  • Possess excellent organizational, interpersonal, and communication skills 

MS Word, Excel & Access skills required

Additional Information

Work Environment

  • The role follows a remote work schedule central hours.
  • Must be able to work in a fast-paced environment and manage multiple tasks with minimal supervision.

What You’ll Get:

  • Comprehensive great inexpensive benefits.
  • Generous paid time off with holidays.
  • Continuous mentoring to further your career path.
  • Great close-knit team environment. We work hard, but we have fun!

Skills Required

  • 3-5 years of experience submitting payer credentialing applications for providers
  • Knowledge of health plans and credentialing for managed care, Medicare, Medicaid replacements, and workers compensation
  • Experience utilizing and maintaining a credentialing database
  • Proficiency with the CAQH database and familiarity with the CAQH Practice Administrator role
  • Established relationships with credentialing representatives at various health plans
  • Experience preparing and processing credentialing applications for all payer types
  • Experience credentialing multi-Tax ID entities
  • Ability to process high-volume credentialing and recredentialing applications
  • Ability to meet turnaround times, credentialing goals, and performance metrics
  • Customer-service orientation and ability to develop relationships
  • Detail-oriented, motivated work ethic and ability to manage projects to deadlines
  • Excellent organizational, interpersonal, and communication skills
  • Microsoft Word, Excel, and Access skills
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The Company
HQ: Houston, Texas
290 Employees
Year Founded: 1990

What We Do

U.S. Physical Therapy is a publicly held company that operates hundreds of outpatient physical and occupational therapy clinics.

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