this job offer closes 2 january 2026

job details

this job offer closes 2 january 2026

summary

hyderabad, telangana
a client of randstad india
permanent

posted 3 november 2025

reference number
JPC - 109855

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job details

Position Overview:

The Provider/Payer Enrollment Specialist is responsible for managing the end-to-end process of enrolling healthcare providers, facilities, or organizations with insurance payers (e.g., Medicare, Medicaid, and private insurers). This role ensures compliance with payer requirements, maintains accurate records, and resolves complex enrollment issues. The Senior Payer Enrollment Specialist also provides guidance to junior staff, streamlines processes, and ensures timely completion of enrollments to support revenue cycle operations.

Key Responsibilities:

...

Payer Enrollment Management:
- Oversee the enrollment and revalidation process for healthcare providers with various payers.
- Prepare, submit, and track enrollment applications to ensure timely approval.
- Verify the accuracy of provider information, including NPI, tax ID, licenses, and certifications.
Compliance and Documentation:
- Ensure compliance with federal, state, and payer-specific regulations.
- Maintain up-to-date knowledge of payer requirements and enrollment guidelines.
- Organize and maintain accurate records of enrollment documents and correspondence.
Issue Resolution:
- Investigate and resolve complex enrollment issues, including application rejections, delays, or discrepancies.
- Liaise with payers, providers, and internal teams to address and resolve enrollment-related challenges.
Process Improvement:
- Identify inefficiencies in the enrollment process and recommend improvements.
- Develop and implement best practices to streamline enrollment workflows.
- Monitor enrollment timelines and ensure deadlines are met.
Training and Support:
- Provide guidance and mentorship to junior enrollment staff.
- Conduct training sessions on payer enrollment processes and systems.
- Serve as a subject matter expert for internal and external stakeholders.
Reporting and Analysis:
- Generate reports on enrollment status, trends, and metrics.
- Analyze data to identify patterns and areas for improvement.
- Communicate enrollment progress and challenges to leadership.

Qualifications & Experience:

Bachelor’s degree in healthcare administration, business, or a related field (preferred).
Experience in payer enrollment, credentialing, or healthcare administration.
In-depth knowledge of payer enrollment processes, including Medicare and Medicaid.
Familiarity with CAQH, NPPES, and other enrollment platforms.
Strong understanding of healthcare regulations and compliance requirements.
Excellent organizational, communication, and problem-solving skills.
Proficiency in Microsoft Office Suite and enrollment software.

experience

Position Overview:

Key Responsibilities:

...

Payer Enrollment Management:
- Oversee the enrollment and revalidation process for healthcare providers with various payers.
- Prepare, submit, and track enrollment applications to ensure timely approval.
- Verify the accuracy of provider information, including NPI, tax ID, licenses, and certifications.
Compliance and Documentation:
- Ensure compliance with federal, state, and payer-specific regulations.
- Maintain up-to-date knowledge of payer requirements and enrollment guidelines.
- Organize and maintain accurate records of enrollment documents and correspondence.
Issue Resolution:
- Investigate and resolve complex enrollment issues, including application rejections, delays, or discrepancies.
- Liaise with payers, providers, and internal teams to address and resolve enrollment-related challenges.
Process Improvement:
- Identify inefficiencies in the enrollment process and recommend improvements.
- Develop and implement best practices to streamline enrollment workflows.
- Monitor enrollment timelines and ensure deadlines are met.
Training and Support:
- Provide guidance and mentorship to junior enrollment staff.
- Conduct training sessions on payer enrollment processes and systems.
- Serve as a subject matter expert for internal and external stakeholders.
Reporting and Analysis:
- Generate reports on enrollment status, trends, and metrics.
- Analyze data to identify patterns and areas for improvement.
- Communicate enrollment progress and challenges to leadership.

Qualifications & Experience:

Bachelor’s degree in healthcare administration, business, or a related field (preferred).
Experience in payer enrollment, credentialing, or healthcare administration.
In-depth knowledge of payer enrollment processes, including Medicare and Medicaid.
Familiarity with CAQH, NPPES, and other enrollment platforms.
Strong understanding of healthcare regulations and compliance requirements.
Excellent organizational, communication, and problem-solving skills.
Proficiency in Microsoft Office Suite and enrollment software.

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