Provider Enrollment Specialist Department: Healthcare Operations / Provider Management
Location: Charlestown, MA | Hybrid/On-Site (40 hours/week)
Role Type: 6-Month Contract Position
About Our Client A leading healthcare provider and managed care organization operating across the Northeast, our client serves hundreds of thousands of members through a comprehensive network of hospitals, clinics, and specialists. Headquartered in Boston with multiple regional centers, they are committed to delivering high-quality, integrated healthcare services and maintaining strong relationships with their extensive provider network. The organization values operational excellence and accurate data management as core pillars of patient access and care quality.
Job Description As a Provider Enrollment Specialist, you will be the backbone of provider network operations, ensuring that healthcare providers are accurately set up and maintained in our systems so members can access care seamlessly and providers receive timely payment. Every day, you'll work with real provider data, manage complex enrollment processes, and solve data discrepancies that directly impact patient care and provider relationships.
You'll work at the intersection of operations and technology, managing provider records across multiple platforms while collaborating with finance, claims, and provider services teams. Your attention to detail and organizational skills will directly support the health plan's ability to serve its network effectively.
This is an ideal role if you're detail-oriented, enjoy problem-solving in fast-paced healthcare environments, and want to understand how managed care operations work from the inside.
Duties and Responsibilities - Accurately set up and maintain provider records in claims processing systems to ensure proper payment and timely claim adjudication.
- Execute all implementation and enrollment steps required to onboard new providers into the health plan network.
- Review, validate, and process provider demographic and credentialing data for accuracy and completeness.
- Identify inaccurate, incomplete, or duplicate provider data and resolve discrepancies in a timely manner.
- Maintain provider information across provider data management and claims processing platforms (ONYX, FACETS, or similar systems).
- Communicate effectively with internal teams including Finance, Claims, and Provider Services regarding enrollment status and data issues.
- Assist with provider data audits, system updates, and ongoing maintenance to ensure data integrity.
- Manage multiple provider enrollment tasks simultaneously while meeting departmental deadlines and service level agreements.
Required Experience / Skills - 2+ years of professional experience in a managed care, healthcare operations, or health plan environment
- Strong organizational and analytical skills with the ability to manage multiple priorities and deadlines
- Attention to detail with demonstrated ability to identify and correct errors in data entry and processing
- Proficiency with Microsoft Office Suite (Word, Excel, Outlook, Access, PowerPoint)
- Experience with or knowledge of provider data systems such as ONYX, FACETS, or similar platforms (OR strong ability to learn new systems quickly)
- Excellent written and verbal communication skills to interact with internal stakeholders and external providers
- Ability to work independently and take ownership of projects while collaborating effectively with team members
- Flexible and adaptable mindset suited to a fast-paced, evolving healthcare environment
Nice-to-Haves - Prior experience with claims processing systems or provider enrollment workflows
- Familiarity with healthcare compliance requirements (HIPAA, network adequacy, etc.)
- Experience using data validation tools or performing quality audits
- Background in provider relations, network development, or healthcare finance
- Knowledge of ICD, CPT codes, or medical billing basics
Education - Bachelor's degree required, OR equivalent combination of professional education, training, and healthcare operations experience
Pay & Benefits SummaryCall-to-Action Ready to support critical healthcare operations? If you have 2+ years of healthcare or managed care experience and strong attention to detail, we want to hear from you.
Apply Now to join our team and make a direct impact on provider network operations and patient access.
Keywords Provider Enrollment | Healthcare Operations | Managed Care | Claims Processing | ONYX | FACETS | Provider Data Management | Data Entry | Healthcare Administration | Medical Records