Provider Enrollment Specialist
Community Health Systems, Inc., Beloit, WI, United States
COMMUNITY HEALTH SYSTEMS, INC.
Job Title : Provider Enrollment Specialist
Date Prepared : March 2026
Location : Community Health Systems, Inc. - Beloit
EEO Category : Admin Workers
Department:
Finance Non-Exempt
Reports to : Billing Specialist Supervisor
JOB SUMMARY
The Provider Enrollment Specialist is responsible for enrolling healthcare providers with insurance payers, maintaining accurate provider records, and ensuring compliance with regulatory and payer requirements. This role plays a critical part in revenue cycle operations by ensuring timely and accurate credentialing and enrollment. The Provider Enrollment Specialist will maintain all current contracts and negotiate rate changes as applicable.
ESSENTIAL JOB FUNCTIONS Prepare and submit provider enrollment applications to commercial, Medicare, and Medicaid payers. Maintain and update provider demographic and credentialing information in internal systems. Monitor application status and follow up with payers to ensure timely approvals. Revalidate and re-credential providers as required by payer guidelines. Ensure compliance with federal, state, and payer-specific regulations. Maintain CAQH profiles and ensure all provider data is current and complete. Collaborate with credentialing, billing, and contracting teams. Resolve enrollment-related issues, including claim rejections due to enrollment errors. Maintain organized records of applications, approvals, and correspondence. Generate reports on enrollment status and turnaround times. PREFERRED EDUCATION & EXPERIENCE
High school diploma required; associate or bachelor's degree preferred. 2+ years of experience in provider enrollment, credentialing, or healthcare administration. Experience with electronic medical record (EMR) and practice management systems. KNOWLEDGE AND ABILITIES
Knowledge of Medicare, Medicaid, and commercial payer enrollment processes. Familiarity with CAQH, PECOS, and NPPES systems. Strong attention to detail and organizational skills. Excellent written and verbal communication skills. Ability to manage multiple priorities and meet deadlines. Understanding of revenue cycle management processes Problem-solving and analytical skills Ability to work independently and in a team environment WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this Job, the employee is frequently exposed to significant work pace/pressure. The noise level in the work environment is usually moderate.
KEY PERFORMANCE INDICATORS (KPIS)
Enrollment turnaround time Accuracy of submissions Number of enrollment errors or rejections Compliance with revalidation deadlines
LINES OF SUPERVISION
The Provider Enrollment Specialist reports to the Billing Specialist Supervisor.
DISCLAIMER: The above statements are intended to describe the general nature and level of work being performed by people assigned to this job class. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
Community Health Systems, Inc. is an equal opportunity employer.
Job Title : Provider Enrollment Specialist
Date Prepared : March 2026
Location : Community Health Systems, Inc. - Beloit
EEO Category : Admin Workers
Department:
Finance Non-Exempt
Reports to : Billing Specialist Supervisor
JOB SUMMARY
The Provider Enrollment Specialist is responsible for enrolling healthcare providers with insurance payers, maintaining accurate provider records, and ensuring compliance with regulatory and payer requirements. This role plays a critical part in revenue cycle operations by ensuring timely and accurate credentialing and enrollment. The Provider Enrollment Specialist will maintain all current contracts and negotiate rate changes as applicable.
ESSENTIAL JOB FUNCTIONS Prepare and submit provider enrollment applications to commercial, Medicare, and Medicaid payers. Maintain and update provider demographic and credentialing information in internal systems. Monitor application status and follow up with payers to ensure timely approvals. Revalidate and re-credential providers as required by payer guidelines. Ensure compliance with federal, state, and payer-specific regulations. Maintain CAQH profiles and ensure all provider data is current and complete. Collaborate with credentialing, billing, and contracting teams. Resolve enrollment-related issues, including claim rejections due to enrollment errors. Maintain organized records of applications, approvals, and correspondence. Generate reports on enrollment status and turnaround times. PREFERRED EDUCATION & EXPERIENCE
High school diploma required; associate or bachelor's degree preferred. 2+ years of experience in provider enrollment, credentialing, or healthcare administration. Experience with electronic medical record (EMR) and practice management systems. KNOWLEDGE AND ABILITIES
Knowledge of Medicare, Medicaid, and commercial payer enrollment processes. Familiarity with CAQH, PECOS, and NPPES systems. Strong attention to detail and organizational skills. Excellent written and verbal communication skills. Ability to manage multiple priorities and meet deadlines. Understanding of revenue cycle management processes Problem-solving and analytical skills Ability to work independently and in a team environment WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this Job, the employee is frequently exposed to significant work pace/pressure. The noise level in the work environment is usually moderate.
KEY PERFORMANCE INDICATORS (KPIS)
Enrollment turnaround time Accuracy of submissions Number of enrollment errors or rejections Compliance with revalidation deadlines
LINES OF SUPERVISION
The Provider Enrollment Specialist reports to the Billing Specialist Supervisor.
DISCLAIMER: The above statements are intended to describe the general nature and level of work being performed by people assigned to this job class. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
Community Health Systems, Inc. is an equal opportunity employer.