Provider Enrollment Specialist

Randstad is looking for the best Provider Enrollment Specialist in the Atlanta market!! This position oversees the full lifecycle of provider credentialing, enrollment, and maintenance across a multi-state telehealth network. This role is a critical driver of the revenue cycle, ensuring that clinicians are properly enrolled in Medicare and Medicaid programs to prevent billing delays, denials, and reimbursement gaps.

The ideal candidate possesses a deep understanding of multi-state Medicare Administrative Contractor (MAC) portals, state-specific Medicaid agencies, and the evolving regulatory landscape of virtual care. Please apply and complete the prescreening questionnaire in order to get on our recruiter's calendar for an interview.

salary: $21 - $22 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School

Responsibilities

Medicare & Medicaid Management

• CMS Compliance: Execute initial enrollments, revalidations, and reassignments through PECOS.
• MAC Navigation: Manage submissions across various MAC portals, resolving PTAN/TIN reassignment issues.
• Medicaid Oversight: Navigate multi-state Medicaid portals, managing state-specific telehealth requirements and rendering/billing provider structures.
• Issue Resolution: Respond to development requests (ADRs), deficiency letters, and Medicare DNF (Do Not Forward) edits to clear billing holds.
• Compliance Screening: Conduct ownership disclosures and OIG exclusion checks to ensure program integrity.

Telehealth-Specific Operations:Virtual Billing Compliance

• Apply deep knowledge of Place of Service (POS) designations, telehealth modifiers, and enrollment location rules.

• Cross-State Coordination: Manage complex enrollment requirements for providers practicing across state lines.

RCM Partnership

• Collaborate with the billing team to proactively identify and close enrollment gaps that threaten revenue.
• Partner with Compliance, Credentialing, and Finance departments to streamline onboarding.
• Provide regular status updates to leadership and develop escalation paths for delayed enrollments.
• Maintain meticulously organized, audit-ready documentation for all provider files.

Skills

• MAC portals (2 years of experience is required)
• CMS-1500 Forms (1 year of experience is required)
• Dispute Resolution (2 years of experience is required)
• Provider Enrollment (3 years of experience is required)
• Medicare/Medicaid enrollments (2 years of experience is required)
• PECOS (2 years of experience is required)

Qualifications

• Years of experience: 3 years
• Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact [email protected].

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.