Provider Enrollment Specialist
Rural Physicians Group, Greenwood Village, CO, United States
Rural Physicians Group is an expansive physician network of rural-focused hospitalists, surgicalists, and APPs that are passionate about helping rural hospitals meet the needs of the communities we serve. By working with Rural Physicians Group, our hospital partners receive full-time dedicated providers on site, filling a critical void in care coverage and allowing for better patient outcomes. Better outcomes lead to expanded inpatient services. Expanded inpatient services revitalize the hospital. And a revitalized hospital improves the entire community.
RPG’s mission is, “Bringing rural hospitals and providers together to enhance the care of their community.”
We are seeking a detail-oriented and highly organized Provider Enrollment Specialist to support our mission by ensuring timely and compliant enrollment of providers across all contracted payors.
Position Summary The Provider Enrollment Specialist is responsible for the end-to-end management of provider enrollment activities, including application submission, revalidation, maintenance, and issue resolution for individual providers, group enrollments, and new practice locations.
This role ensures regulatory compliance, mitigates reimbursement risk, and maintains uninterrupted billing capability across all payor contracts.
Essential Duties May be required to do one or all of the following dependent on the business needs (including but not limited to):
Enrollment & Application Management
Prepare, complete, and submit enrollment and revalidation applications for Medicare, Medicaid (in-state and out-of-state), MCOs, and commercial payors
Manage both individual and group enrollments, including new TINs and new service locations
Coordinate Medicare Part A, Part B, and facility alignments as applicable
Monitor application status and conduct routine follow-ups to prevent enrollment delays
CAQH & Credentialing Support
Maintain and attest CAQH profiles for all assigned providers
Ensure documentation accuracy (licenses, DEA, board certifications, malpractice coverage, W-9s, etc.)
Support delegated credentialing processes as required
Compliance & Risk Mitigation
Maintain tracking systems to prevent lapses in enrollment or billing eligibility
Monitor payor revalidation cycles and proactively initiate renewals
Ensure compliance with federal, state, and payor-specific regulations
Safeguard confidential provider and organizational information in accordance with HIPAA and company policy
Contract & Operational Coordination
Track enrollment status in alignment with executed payor contracts
Assist in onboarding new providers and expanding services to new hospital partners
Collaborate with Contracting, Credentialing, Revenue Cycle, and Hospital Leadership teams
Issue Resolution & Communication
Respond to payor correspondence and provider inquiries in a timely and professional manner
Escalate complex enrollment issues appropriately
Effectively manage escalated conversations with diplomacy and professionalism
Reporting & Process Improvement
Maintain accurate enrollment logs and dashboards
Support leadership reporting related to enrollment timelines and risk exposure
Identify workflow improvements to enhance efficiency and compliance
Additional Duties
Perform other duties as assigned to support departmental and organizational goals
Skills and Qualifications
Minimum 2 years of Provider Enrollment experience in a healthcare setting
Strong working knowledge of Medicare, Medicaid, and commercial payor enrollment processes
Experience managing CAQH profiles and payor portals
High attention to detail and strong organizational skills
Ability to prioritize workload in a fast-paced, evolving environment
Strong analytical and problem-solving abilities
Excellent written and verbal communication skills
Ability to work independently and collaboratively across departments
Proficiency in Microsoft Excel and provider tracking systems
Associate’s degree or relevant certification preferred
Bachelor’s degree in Business, Healthcare Administration, or related field preferred
Benefits
Competitive salary
Incentivized bonus plan
Ability to work remotely from home
Three weeks of paid time off, accrual starting first day
Comprehensive medical, dental, and vision insurance plans
401(k) with company match
Health Savings Account
Basic Life Insurance coverage
Cell Phone Allowance
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RPG’s mission is, “Bringing rural hospitals and providers together to enhance the care of their community.”
We are seeking a detail-oriented and highly organized Provider Enrollment Specialist to support our mission by ensuring timely and compliant enrollment of providers across all contracted payors.
Position Summary The Provider Enrollment Specialist is responsible for the end-to-end management of provider enrollment activities, including application submission, revalidation, maintenance, and issue resolution for individual providers, group enrollments, and new practice locations.
This role ensures regulatory compliance, mitigates reimbursement risk, and maintains uninterrupted billing capability across all payor contracts.
Essential Duties May be required to do one or all of the following dependent on the business needs (including but not limited to):
Enrollment & Application Management
Prepare, complete, and submit enrollment and revalidation applications for Medicare, Medicaid (in-state and out-of-state), MCOs, and commercial payors
Manage both individual and group enrollments, including new TINs and new service locations
Coordinate Medicare Part A, Part B, and facility alignments as applicable
Monitor application status and conduct routine follow-ups to prevent enrollment delays
CAQH & Credentialing Support
Maintain and attest CAQH profiles for all assigned providers
Ensure documentation accuracy (licenses, DEA, board certifications, malpractice coverage, W-9s, etc.)
Support delegated credentialing processes as required
Compliance & Risk Mitigation
Maintain tracking systems to prevent lapses in enrollment or billing eligibility
Monitor payor revalidation cycles and proactively initiate renewals
Ensure compliance with federal, state, and payor-specific regulations
Safeguard confidential provider and organizational information in accordance with HIPAA and company policy
Contract & Operational Coordination
Track enrollment status in alignment with executed payor contracts
Assist in onboarding new providers and expanding services to new hospital partners
Collaborate with Contracting, Credentialing, Revenue Cycle, and Hospital Leadership teams
Issue Resolution & Communication
Respond to payor correspondence and provider inquiries in a timely and professional manner
Escalate complex enrollment issues appropriately
Effectively manage escalated conversations with diplomacy and professionalism
Reporting & Process Improvement
Maintain accurate enrollment logs and dashboards
Support leadership reporting related to enrollment timelines and risk exposure
Identify workflow improvements to enhance efficiency and compliance
Additional Duties
Perform other duties as assigned to support departmental and organizational goals
Skills and Qualifications
Minimum 2 years of Provider Enrollment experience in a healthcare setting
Strong working knowledge of Medicare, Medicaid, and commercial payor enrollment processes
Experience managing CAQH profiles and payor portals
High attention to detail and strong organizational skills
Ability to prioritize workload in a fast-paced, evolving environment
Strong analytical and problem-solving abilities
Excellent written and verbal communication skills
Ability to work independently and collaboratively across departments
Proficiency in Microsoft Excel and provider tracking systems
Associate’s degree or relevant certification preferred
Bachelor’s degree in Business, Healthcare Administration, or related field preferred
Benefits
Competitive salary
Incentivized bonus plan
Ability to work remotely from home
Three weeks of paid time off, accrual starting first day
Comprehensive medical, dental, and vision insurance plans
401(k) with company match
Health Savings Account
Basic Life Insurance coverage
Cell Phone Allowance
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