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Provider Enrollment Representative II
R1 RCMProvider enrollment representative processing payer applications and credentialing records for R1, a healthcare revenue management company. Supporting providers, insurers, and client teams through enrollment, re-enrollment, CAQH, and NPPES workflows.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in provider enrollment processes, including managing applications for commercial, Medicare, and Medicaid payers, while ensuring compliance with policies and achieving quality standards. Proficient in data entry, CAQH application facilitation, and NPPES record updates.
Highest-signal resume keywords
Provider Enrollment ManagementData Entry SkillsCAQH Application FacilitationNPPES Record UpdatesPayer Portal Utilization
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Provider EnrollmentData EntryApplication SubmissionCAQH ApplicationsNPPES Updates
Soft Skills
CommunicationCollaborationProblem-Solving
Tools & Technologies
Payer Online Portals
Industry Keywords
Commercial PayersMedicareMedicaidQuality StandardsProductivity Standards
About the role
Key responsibilities & impact- Work in all phases of provider enrollment, re-enrollment, and expirables management for commercial and government payers
- Enter and maintain current expirables, practice/billing locations, and other pertinent information in the payer enrollment database
- Participate in reviewing, completing, and submitting provider enrollment initial and re-enrollment applications through payer portals and other applicable methods
- Follow up with payers by phone, website, or email regarding network participation and submitted applications
- Assist providers and client personnel with application completion
- Monitor application status and resolve issues with insurance carriers
- Facilitate completion, setup, and re-attestations of CAQH applications
- Update NPPES records for individual and organization providers
- Coordinate and collaborate professionally with providers and designated office personnel
- Achieve monthly quality and productivity standards
- Comply with R1 policies
- Perform other duties assigned by Provider Enrollment leadership
- Assist with auditing, training, and educating peers and client team members on escalations, enrollment processes, and paperwork
- Identify gaps and trends in enrollment processes and escalate them to leadership for resolution
Requirements
What you’ll need- High school education level
- Equivalent experience will be considered
- Minimum of 2 years of experience
- Accurate data entry skills
- Ability to work with commercial, Medicare, and Medicaid payers
- Ability to use payer online portals and other application submission methods
- Ability to follow up with payers by phone, website, and email
- Ability to facilitate CAQH applications
- Ability to update NPPES records
- Ability to meet monthly quality and productivity standards
- Licenses and certifications not specified
Benefits
Comp & perks- Competitive benefits package
- Opportunity to constantly learn, collaborate across groups, and explore new career paths
- Opportunity to contribute meaningful work that makes a difference in communities
- Community involvement and giving back
- Reasonable accommodation for applicants with disabilities