CrawlJobs Logo

Enrollment Specialist

https://www.roberthalf.com Logo

Robert Half

Location Icon

Location:
United States , Greenwood Village

Category Icon
Category:
-

Job Type Icon

Contract Type:
Not provided

Salary Icon

Salary:

Not provided
Save Job
Save Icon
Apply Position

Job Description:

We’re seeking a Credentialing/Enrollment Specialist to support the enrollment of businesses—not patients—into Medicare, Medicaid, and other payer networks. This role plays a critical part in our operational workflow and requires precision, strong documentation skills, and the ability to manage large volumes of data with accuracy. You'll partner closely with internal teams across Operations, Legal, and Compliance, ensuring that every credentialing and contracting submission is complete, timely, and compliant.

Job Responsibility:

  • Prepare and submit accurate payer enrollment applications—both digital and paper-based—for healthcare organizations
  • Complete credentialing and contracting requests with exceptional accuracy and attention to detail
  • Gather necessary licenses, compliance documents, and supporting materials from internal teams
  • Maintain and track all credentialing activity through company software and internal tracking systems
  • Update business information, maintain confidentiality, and ensure records are current and compliant
  • Conduct research, compile data, and assist with reporting as needed
  • Contribute to special projects and support other operational tasks
  • Adhere to company policies and standard operating procedures at all times

Requirements:

  • Prior experience in healthcare credentialing or payer enrollment strongly preferred—especially enrolling organizations rather than individual providers
  • Working knowledge of Medicare and Medicaid enrollment processes
  • At least 1 year of related experience, or a combination of education and experience
  • Proficiency with Microsoft Office (Word, Excel, Access, PowerPoint, Outlook)
  • Ability to collect, organize, and synthesize data into clear reports
  • Strong judgment and the ability to manage confidential information appropriately
  • Exceptionally organized with high attention to detail and consistent follow-through
  • Comfortable working with shifting priorities and meeting deadlines under time constraints
  • Familiarity with medical and/or legal terminology
  • Clear, professional communication—both written and verbal
  • Ability to collaborate effectively with team members across departments
  • Competence using standard office equipment (multi-line phones, scanners, copiers, fax machines)
  • Typing speed of at least 40 WPM

Nice to have:

  • Loves structured, behind‑the‑scenes, detail‑oriented work
  • Takes pride in accuracy, compliance, and well‑organized workflows
  • Wants to contribute to a team that supports businesses in navigating the complexities of healthcare payer systems
What we offer:
  • medical
  • vision
  • dental
  • life and disability insurance
  • eligible to enroll in company 401(k) plan

Additional Information:

Job Posted:
January 29, 2026

Icon
Robert Half - All Job Offers
Job Link Share:
Copy Link Icon
Facebook Icon Twitter Icon LinkedIn Icon

Looking for more opportunities? Search for other job offers that match your skills and interests.

Briefcase Icon

Similar Jobs for Enrollment Specialist

Provider Enrollment Specialist II - HP Enrollment Eligibility

Coordinates Medicare and Medicaid enrollment/re-enrollment and managed care cred...
Location
Location
United States , Irving
Salary
Salary:
Not provided
christushealth.org Logo
CHRISTUS Health
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • High School Diploma
  • 1-3 years of Payer Enrollment experience
  • Solid knowledge and utilization of PC applications to include WORD, EXCEL, ACCESS
  • Excellent written and verbal communication skills
  • Excellent organization and planning skills with demonstrated teamwork skills
  • Proven ability to interact with all levels of management and other Associates
Job Responsibility
Job Responsibility
  • Collects and maintains data on providers for Medicare and Medicaid enrollment
  • Prepares and submits applications to Medicare and Medicaid for new provider enrollments and existing provider updates
  • follows up by telephone or in writing, with carriers regarding application status
  • Complies with Medicare and Medicaid provider enrollment guidelines
  • Requests NPI numbers for providers and clinics as necessary and maintains NPI files
  • Follows up, either by telephone or in writing, with insurance companies and patients regarding the processing of outstanding claims and/or appeals
  • Generates various reports to identify outstanding claims issues with provider numbers and non-payment
  • Communicates information to appropriate personnel
  • Educates staff on corrections, e.g.. front-end entry errors in a positive, constructive manner
  • Collects and reviews managed care contracts for correct billing and payment terms
  • Fulltime
Read More
Arrow Right

Outbound Enrollment Specialist

As an Outbound Enrollment Representative, you will be responsible for making out...
Location
Location
United States
Salary
Salary:
40000.00 - 50000.00 USD / Year
pomelocare.com Logo
Pomelo Care
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Ability to work Monday-Friday, 8:30am - 5:00pm CT
  • Strong, empathetic communication skills
  • Motivated by goals, metrics, and monthly bonus program
  • Passionate about changing the current landscape of healthcare
  • Strong organizational and time-management skills
  • Ability to work independently and as part of a team
  • Willing to work occasional overtime hours
  • Are internet-connected, able to work remotely
Job Responsibility
Job Responsibility
  • Conduct high volume outbound calls to patients to provide information and education about Pomelo Care services and resources
  • Achieve member enrollment goals as driven by company KPIs
  • Support patients by answering their questions, addressing their concerns, and providing guidance on how Pomelo can support their needs
  • Document all interactions and maintain timely, accurate records of patient outreach activities
  • Collaborate internally and externally with healthcare providers, community organizations, and other stakeholders to ensure patients receive appropriate care and services
  • Work with families to schedule appointments and follow-up care as needed
  • Participate in training and development opportunities to stay current on healthcare trends and regulations
  • Manage inbound calls from potential patients
What we offer
What we offer
  • Competitive healthcare benefits
  • Generous vacation policy
  • Membership in the First Round Network (a curated and confidential community with events, guides, thousands of Q&A questions, and opportunities for 1-1 mentorship)
  • Uncapped performance bonus paid out monthly
  • Fulltime
Read More
Arrow Right

Bilingual Outbound Enrollment Specialist

As an Outbound Enrollment Representative, you will be responsible for making out...
Location
Location
United States
Salary
Salary:
45000.00 - 55000.00 USD / Year
pomelocare.com Logo
Pomelo Care
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Ability to work Monday-Friday, 8:30am - 5:00pm CT
  • Fluent in Spanish and English
  • Strong, empathetic communication skills
  • Motivated by goals, metrics, and monthly bonus program
  • Passionate about changing the current landscape of healthcare
  • Strong organizational and time-management skills
  • Ability to work independently and as part of a team
  • Willing to work occasional overtime hours
  • Are internet-connected, able to work remotely
Job Responsibility
Job Responsibility
  • Conduct high volume outbound calls to patients to provide information and education about Pomelo Care services and resources
  • Achieve member enrollment goals as driven by company KPIs
  • Support patients by answering their questions, addressing their concerns, and providing guidance on how Pomelo can support their needs
  • Document all interactions and maintain timely, accurate records of patient outreach activities
  • Collaborate internally and externally with healthcare providers, community organizations, and other stakeholders to ensure patients receive appropriate care and services
  • Work with families to schedule appointments and follow-up care as needed
  • Participate in training and development opportunities to stay current on healthcare trends and regulations
  • Manage inbound calls from potential patients
What we offer
What we offer
  • Competitive healthcare benefits
  • Generous vacation policy
  • Membership in the First Round Network (a curated and confidential community with events, guides, thousands of Q&A questions, and opportunities for 1-1 mentorship)
  • Uncapped performance bonus paid out monthly
  • Fulltime
Read More
Arrow Right

Brand Sales Specialist Intern

Technology sales at IBM is evolving its way of working to break beyond boundarie...
Location
Location
United States , Brookhaven, RESEARCH TRIANGLE PARK, Dallas, Austin, San Francisco, Costa Mesa, WASHINGTON, Cambridge, Chicago, New York
Salary
Salary:
72000.00 - 132000.00 USD / Year
ibm.com Logo
IBM Deutschland GmbH
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Actively Enrolled: Registered undergraduate or graduate university student
  • Technical Education: Seeking B.S. or M.S degree in Business/Communications with a STEM minor, Computer Science, Engineering, Information Systems, or similar technical disciplines
  • Client Focused: Asks open-ended questions and understands needs to address business challenges
  • Tech Savvy: Conversant about technology, latest industry trends and how it is being applied to address business challenges
  • Team Player: Demonstrates team collaboration and can navigate different communication styles
  • Excellent Communication Skills: Possess verbal, written, and interpersonal skills that are engaging, compelling and influential
  • Self-Starter: Motivated to work with clients and can lead projects independently
  • Confidence to contact and engage potential new customers and deliver an elevated experience
  • Motivation to achieve sales, business objectives and high client satisfaction
  • Aptitude to utilize selling technologies to network, engage clients, and identify new business opportunities
Job Responsibility
Job Responsibility
  • Sales Prospecting: Apply IBM’s sales methodology to identify new clients and opportunities for expansion with existing clients through multiple channels (email, phone, video creation, social media) - this includes a considerable amount of cold calling
  • Building Credibility and Trust: Through consultative methods at all levels, both internally and externally, to facilitate the closure of highly complex deals
  • Solution-Selling Expertise in Business Development: Apply solution-selling skills to identify and engage decision makers and influencers, assess business opportunities, and address clients' requirements to establish enduring, strategic partnerships
  • End-to-End Sales Process Management: Assist with the complete sales process, encompassing RFI/RFP response preparation and ensure the attainment of KPIs, with a notable emphasis on new business sales, while also extending services to existing accounts
  • Collaboration Across IBM Sales Ecosystem: Collaborate with the broader IBM sales ecosystem, from Marketing to Sales and technical colleagues, as well as IBM Business Partners, to formulate sales campaigns and augment the pipeline
What we offer
What we offer
  • Supplemental 1 employees may be eligible for up to 8 paid holidays, minimum of 56 hours paid sick time and the IBM Employee Stock Purchase Plan
  • IBM offers paid family medical leave and disability benefits to eligible employees where required by applicable law
  • Fulltime
Read More
Arrow Right

Entitlement advocate

The Enrollment Medicaid Specialists provides Healthfirst’ s Medicare Advantage P...
Location
Location
United States , New York
Salary
Salary:
48600.00 - 65960.00 USD / Year
healthfirst.org Logo
Healthfirst
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • High school diploma or GED from an accredited institution
  • Member facing or customer service experience
  • Be able to work 9am-5:30pm schedule
  • Be able to travel throughout the 5 boroughs, Westchester, Orange, Sullivan, Rockland, and Nassau County
  • Capability to work in a Hybrid Schedule (remote/office/field)
  • Tech Savvy computer skills such as Microsoft Office Suites: Outlook, Excel, Word, PowerPoint
  • Bilingual
  • Be able to communicate and engage with the leadership team on virtual platforms such as Zoom or Microsoft Teams chat as well as in person
Job Responsibility
Job Responsibility
  • Handle inbound and outbound calls to and from customers to address their needs while adhering to our service level goals
  • Screen all incoming calls and handles accordingly
  • Transfer calls to appropriate staff, unit, or department
  • Assist callers requesting assistance with Medicaid Renewal application, Medicare Savings Program application, and New Medicaid Applications
  • Outreach Senior Health Partners, CompleteCare, and Life Improvement Plan members according to approved scripts
  • Research ePACES and/or Marx for Medicaid and Medicare eligibility, exclusion, and exemption codes
  • Consult with HRA Medicaid staff as needed and report to supervisor any need for HRA consultation
  • Document all client calls /outcomes in database systems
  • Schedule appointments to see members/prospects out in the field to assist with Medicaid Issue or restriction code removals or demographic information changes
  • Educate potential members on Senior Health Partners, Long term care plan benefits answering questions regarding plan’s features and benefits as well as go through eligibility and requirement for enrollment
What we offer
What we offer
  • medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions
  • Fulltime
Read More
Arrow Right

Outreach & Engagement Manager

Managing and motivating teams to drive enrollment. Drive enrollment and activati...
Location
Location
United States
Salary
Salary:
90000.00 - 115000.00 USD / Year
pomelocare.com Logo
Pomelo Care
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Earned your Bachelor's degree in healthcare management, public health, or a related field
  • Able to work some evenings, with a standard schedule of Monday - Friday, 8:30am - 5:00pm CST
  • Proven experience in healthcare management, specifically in outbound calling and proactive outreach
  • Strong knowledge of Medicaid policies, procedures, and value-based care
  • Excellent communication and interpersonal skills to engage with diverse patient populations
  • Demonstrated leadership abilities, with experience in managing and motivating teams
  • Proficient in data analysis and reporting, using metrics to drive performance improvements
  • Detail-oriented, with exceptional organizational and documentation skills
  • Ability to adapt to changing priorities and work effectively in a fast-paced environment
  • Familiarity with healthcare software systems and customer relationship management (CRM) tools
Job Responsibility
Job Responsibility
  • Lead, and manage a team of outreach specialists providing regular training, and coaching to achieve enrollment KPIs
  • Facilitate onboarding and training of new specialists
  • Analyze qualitative and quantitative outreach performance metrics to identify trends and opportunities to improve key KPIs including enrollments and CAC
  • Monitor call quality and adherence to established protocols and standards by conducting regular audits of call recordings and specialist interactions
  • Maintain accurate and up-to-date documentation of specialist interactions, outcomes, and follow-up actions, adhering to privacy and confidentiality regulations
  • Identify opportunities and implement process improvements to enhance the efficiency and effectiveness of outbound and inbound calling
  • Execute on regular performance evaluations of outreach specialist calls and documentation
  • Create and maintain team schedules to ensure adequate coverage
  • Ensure compliance with government regulations and guidelines in all outbound calling and outreach activities
  • Foster a supportive and inclusive team environment, encouraging professional growth and development
What we offer
What we offer
  • Competitive healthcare benefits
  • Generous equity compensation
  • Unlimited vacation
  • Membership in the First Round Network (a curated and confidential community with events, guides, thousands of Q&A questions, and opportunities for 1-1 mentorship)
  • Fulltime
Read More
Arrow Right

Provider Enrollment Specialist

The Provider Enrollment Specialist ensures seamless plan enrollment (initial and...
Location
Location
United States , St. Louis
Salary
Salary:
21.00 - 27.00 USD / Hour
anderscpa.com Logo
Anders Minkler Huber & Helm LLP
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Associate degree, preferred
  • High School diploma or GED required
  • 3-5 years of experience in payer enrollment
  • Strong organizational and time management skills, with the ability to manage multiple tasks and meet deadlines
  • Excellent attention to detail and accuracy in data entry and record-keeping
  • Effective communication skills, both written and verbal, with the ability to interact professionally with providers, staff and external entities
  • Ability to work independently and as part of a team, demonstrating flexibility and adaptability
  • Strong problem-solving skills, with the ability to identify and resolve issues promptly and effectively
  • Knowledge of healthcare regulations and compliance requirements
  • Familiarity with NCQA, URAC, and CMS standards
Job Responsibility
Job Responsibility
  • Process and submit initial provider applications, revalidations, and renewal applications in compliance with NCQA, URAC, and CMS accreditation standards
  • Perform thorough and accurate data entry and verification of provider information into credentialing databases
  • Conduct timely follow-up on missing or incomplete information with the provider, client, or team lead responsible for a provider file to ensure prompt and efficient provider enrollment
  • Assist in the preparation and submission of required documentation for provider enrollment and credentialing to include delegation rosters
  • Coordinate with internal staff and external entities to resolve issues related to provider enrollment and credentialing
  • Monitor and track the status of provider applications, payer directories, conducting regular follow-up with health plans until verification of completion is received from each payor
  • Support the enrollment and delegation team with various tasks as needed
What we offer
What we offer
  • Work Flex program which gives you the opportunity to work at our Chesterfield office, our Downtown St. Louis office, remotely, adopt a hybrid approach or even switch between these options as you prefer
  • Professional development opportunities
  • Benefits that directly impact mental, physical and financial wellness
  • Fulltime
Read More
Arrow Right

Payer Delegation and Compliance Specialist

The Payer Delegation and Compliance Specialist at A5 Healthcare serves a critica...
Location
Location
United States , St. Louis; Tulsa
Salary
Salary:
68500.00 - 81500.00 USD / Year
anderscpa.com Logo
Anders Minkler Huber & Helm LLP
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Proven leadership ability and experience mentoring or training junior staff
  • Advanced understanding of CVO credentialing workflows, payer delegation requirements, and NCQA regulatory compliance
  • High-level organizational and problem-solving skills with keen attention to detail
  • Excellent written and verbal communication
  • capable of handling sensitive issues with professionalism
  • Proficient in credentialing and enrollment systems, with strong Excel and Microsoft Office Suite skills
  • Self-directed, accountable, and capable of managing priorities in a fast-paced remote environment
  • Associate’s degree required
  • Bachelor’s degree in healthcare administration or a related field preferred
  • Minimum 5 years of experience in delegation and compliance, payer enrollment or healthcare credentialing, including experience with NCQA, URAC, and CMS standards
Job Responsibility
Job Responsibility
  • Payer Delegation: NCQA standards (understand and identify changes necessary to comply with NCQA standards)
  • CAQH Application retrieval and review
  • File Audit and Analysis for inappropriate documentation and updates to credentialing information
  • Conduct qualitative analysis of inappropriate documentation and updates
  • Payer Rosters must be completed in accordance with A5’s policy and procedures
  • Credentialing Information Integrity
  • Policy and procedure (writing and updating in accordance with payer and NCQA standards)
  • Trouble shoot and problem solve implementation challenges related to NCQA standards, policy, and procedures
  • Evolution of system controls requirements
  • Team Collaboration: Communicate regularly with the non-delegated provider enrollment and CVO teams
What we offer
What we offer
  • Work Flex program which gives you the opportunity to work at our Chesterfield office, our Downtown St. Louis office, remotely, adopt a hybrid approach or even switch between these options as you prefer
  • Professional development opportunities
  • Benefits that directly impact mental, physical and financial wellness
  • Fulltime
Read More
Arrow Right
Jobs by Category
Art and Entertainment Jobs Banking Jobs Call Center Jobs Construction Jobs Consulting Jobs Customer Service Jobs Education Jobs Energy Jobs Finance Jobs Gastronomy Jobs Health and Beauty Jobs Hospitality and Tourism Jobs Human Resources Jobs Insurance Jobs IT - Administration Jobs IT - Software Development Jobs Legal Jobs Logistics Jobs Manufacturing Jobs Marketing, Digital Marketing, SEO, SEM Jobs Media Jobs Nursing Jobs Office Administration Jobs Pharmacy Jobs Physical Work Jobs Public Relations Jobs Public Sector Jobs Purchasing Jobs Quality Control Jobs Real Estate Jobs Research and Development Jobs Sales Jobs
Job Positions Jobs by Country
United States Jobs United Kingdom Jobs India Jobs Canada Jobs Australia Jobs Germany Jobs Ireland Jobs Poland Jobs
Company
Blog About Us Contact
Follow Us
Facebook
X (Twitter)
LinkedIn
Instagram
CrawlJobs Group
ITFlashcards AllDevBlogs
© 2026 CrawlJobs Ltd. All Rights Reserved
Terms & Conditions Privacy Policy