Job Summary
The Provider Enrollment Representative is responsible for enrolling, credentialing, and maintaining healthcare provider records with insurance payers, government programs, and internal systems. This role ensures providers are properly enrolled, compliant with regulatory requirements, and activated in a timely manner to support accurate billing and reimbursement.

Key Responsibilities

• Complete provider enrollment, re-enrollment, and updates with commercial payers, Medicaid, Medicare, and other government programs

• Prepare, submit, and track enrollment and credentialing applications (paper and electronic)

• Maintain provider data in enrollment systems, credentialing databases, and practice management platforms

• Monitor application status and follow up with payers to resolve delays or deficiencies

• Ensure compliance with payer, state, and federal regulations (CMS, Medicaid guidelines, HIPAA)

• Process provider terminations, demographic changes, and reassignments

• Collaborate with billing, credentialing, and compliance teams to ensure providers are active and billable

• Communicate with providers regarding required documentation and enrollment status

• Maintain accurate records, audit trails, and documentation for all enrollment activities

• Identify and resolve enrollment-related denials or reimbursement issues

Required Qualifications

• High school diploma or equivalent (Associate’s or Bachelor’s degree preferred)

• 1–3+ years of experience in provider enrollment, credentialing, or healthcare administration

• Knowledge of Medicare, Medicaid, and commercial payer enrollment processes

• Familiarity with CAQH, PECOS, and payer portals

• Strong attention to detail and organizational skills

• Ability to manage multiple applications and deadlines simultaneously

• Proficiency with Microsoft Office and healthcare management systems

• Strong written and verbal communication skills

Ascendo is a certified minority owned staffing firm, and we welcome and celebrate diversity. Ascendo is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, parental status, military service or any other characteristic protected by federal, state or local law.

Contact information

Hakeem Peterson