Mission of the Role
To ensure timely and accurate follow-up with payers for provider enrollment applications by using professional phone and email communication, resolving pending issues, and supporting the enrollment lifecycle through high-quality interactions.
Key Responsibilities
1. Payer Follow-ups & Communication
● Make outbound calls and send professional emails to payers, enrollment departments,
and provider relations teams to check the status of submitted applications.
● Document all communication accurately and update status trackers/CRM systems in real
time.
● Maintain strong phone/email etiquette to represent the provider and the organization
professionally.
2. Enrollment Status Management
● Track all submitted applications—new enrollment, revalidation, demographic updates,
and terminations.
● Identify missing information, additional documentation requirements, or payer-specific
clarifications.
● Escalate urgent or stuck applications to the Senior Analyst/Team Lead.
3. Issue Identification & Resolution
● Research and troubleshoot issues such as incorrect provider data, incomplete
documentation, NPI/taxonomy mismatches, or portal discrepancies.
● Coordinate with internal teams (Enrollment, Credentialing, Data Management) to resolve
blockers and re-submit required information.
● Ensure timely follow-up cycles to avoid processing delays.
4. Compliance & Documentation
● Adhere to payer-specific guidelines, call handling standards, and documentation norms.
● Ensure all communication, follow-ups, and payer responses are captured accurately for
audit and compliance purposes.
● Follow HIPAA and internal confidentiality standards.

5. Workflow & Productivity Management
● Work efficiently through daily call queues and email follow-up tasks.
● Prioritize escalations and time-sensitive cases based on SLO/TAT expectations.
● Participate in huddles, training sessions, and process updates as required.

Required Qualifications
● Experience in Provider Enrollment OR Healthcare Voice Processes
such as AR calling, RCM calling, prior authorization, or patient services.
● Strong phone etiquette, email writing skills, and clarity in communication.
● Ability to handle payer conversations confidently and professionally.
● Basic understanding of healthcare provider types, NPI, CAQH, and payer enrollment
workflows (preferred but not mandatory).
● Comfortable working in a fast-paced, metric-driven operational environment.

Preferred Skills
● Experience using payer portals, CRM tools, or workflow management systems.
● Exposure to provide credentialing or healthcare operations.
● Ability to identify issues and communicate them effectively to senior team members.

Work Environment & Expectations
● Work From Office – Hyderabad (mandatory).
● Requires strong discipline in documentation, follow-up cycles, and adherence to
communication standards.
● Willingness to work aligned to U.S. payer hours as required.--

experience

4