Experience Required: 1–3 years in healthcare voice processes (Provider Enrollment preferred, but AR/RCM/Healthcare Voice also acceptable)
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
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
1–3 years of 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.
experience
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