Enrollment Coordinator

General Summary

Submits and manages payer enrollment activities for providers and applicable entities. Tracks applications through completion, maintains accurate enrollment records, and coordinates with internal partners to support timely billing readiness and network participation.

Duties and Responsibilities

Essential Functions:

• Prepares and submits payer enrollment applications for providers and applicable entities, including initial, revalidation, updates, and terminations.


• Submits enrollment information through payer portals and required systems (e.g., CAQH and other payer-designated platforms) and documents all actions.


• Tracks enrollment submissions, follow-ups, provider numbers, and effective dates; maintains accurate enrollment status logs and records.


• Coordinates demographic, practice location, and billing updates with payers and internal partners to ensure data accuracy across systems.


• Communicates enrollment status and effective dates to practices, Revenue Cycle, and other stakeholders to support billing readiness.


• Works with payer representatives to resolve missing information, application rejections, and processing delays.


• Assists with identifying and resolving enrollment-related claim or billing issues by researching enrollment history and coordinating corrective actions.


• Runs routine enrollment reports (pending, effective dates, revalidation due) and initiates follow-up to meet timelines.


• Maintains confidentiality and complies with organizational privacy and information security standards.

Common Expectations:

• Maintains established policies and procedures, objectives, quality assessment and safety standards.


• Maintains professional growth and development.


• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

Qualifications

Minimum Education:

• High School Diploma or GED Required


• Associates Degree or higher in a related field Preferred

Work Experience:

• 2 years Relevant experience in provider enrollment, credentialing, payer relations, or healthcare administrative operations Required


• Experience using payer portals and tracking enrollment effective dates and provider identifiers Preferred

Licenses:

• Certified Provider Credentialing Specialist Upon Hire Preferred or


• Certified Professional Medical Services Management Upon Hire Preferred

Courses and Training:

• NAMSS certification (PECS) Upon Hire Preferred

Knowledge, Skills, and Abilities:

• Strong attention to detail and ability to manage multiple priorities while meeting deadlines


• Proficiency with Microsoft Office (Outlook, Excel, Word) and ability to learn credentialing/enrollment systems


• Effective written and verbal communication skills with providers, payers, and internal stakeholders


• Ability to interpret policies, procedures, and payer/agency requirements and apply them consistently


• Demonstrated discretion and ability to maintain confidentiality of sensitive information


• Working knowledge of provider enrollment concepts including effective dates, provider identifiers, and payer participation requirements

Benefits Offered:

• Comprehensive health benefits


• Retirement savings plan


• Paid time off (PTO)


• Education assistance


• Financial education and support, including DailyPay


• Expanded Paid Parental Leave

For additional details: Benefits & Incentives | WellSpan Careers (joinwellspan.org)