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Medicare Provider Enrollment Analyst Jobs (NOW HIRING)

Denver Health

Provider Enrollment Specialist I

$24.33 - $34.06/hr

... Medicare, Medicaid and Dental Plans enrollments for the Medical Staff and Advanced Practice ... interpreting, analyzing, and researching data (5%) * Proactively obtains updated provider ...

Denver Health

Provider Enrollment Specialist I

Denver, CO · On-site

$24.33 - $34.06/hr

... Medicare, Medicaid and Dental Plans enrollments for the Medical Staff and Advanced Practice ... interpreting, analyzing, and researching data (5%) * Proactively obtains updated provider ...

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How much do medicare provider enrollment analyst jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for medicare provider enrollment analyst in the United States is $23.80, according to ZipRecruiter salary data. Most workers in this role earn between $19.23 and $26.20 per hour, depending on experience, location, and employer.

What does a Medicare Provider Enrollment Analyst do?

A Medicare Provider Enrollment Analyst is responsible for reviewing and processing applications from healthcare providers who wish to enroll in the Medicare program. They verify credentials, ensure compliance with federal regulations, and maintain accurate records to support provider participation. Analysts may also communicate with providers to resolve discrepancies or request additional information, and they play a key role in preventing fraud and ensuring only qualified providers are approved. Their work helps maintain the integrity of the Medicare system and ensures beneficiaries receive care from eligible providers.

What are some common challenges Medicare Provider Enrollment Analysts face when processing provider applications?

Medicare Provider Enrollment Analysts often encounter challenges such as navigating complex federal regulations, verifying incomplete or inconsistent provider documentation, and staying updated with frequent policy changes. These analysts must be detail-oriented to ensure all required information is accurate and compliant, as errors can delay provider approval and patient care. Collaboration with providers, internal teams, and regulatory agencies is essential to resolve issues quickly and efficiently.

What are the key skills and qualifications needed to thrive as a Medicare Provider Enrollment Analyst, and why are they important?

To thrive as a Medicare Provider Enrollment Analyst, you need a solid understanding of healthcare regulations, provider credentialing, and Medicare enrollment processes, often supported by a bachelor’s degree in healthcare administration or a related field. Familiarity with Medicare's Provider Enrollment, Chain, and Ownership System (PECOS), as well as document management and compliance tracking tools, is typically required. Strong attention to detail, analytical thinking, and effective communication skills help analysts navigate complex regulations and ensure accurate provider data. These skills are critical for ensuring timely provider enrollment, maintaining regulatory compliance, and minimizing disruptions in healthcare services.

What is the difference between Medicare Provider Enrollment Analyst vs Medicare Claims Specialist?

AspectMedicare Provider Enrollment AnalystMedicare Claims Specialist
Required CredentialsTypically requires healthcare or administrative certifications, knowledge of Medicare policiesOften requires claims processing certifications, familiarity with billing systems
Work EnvironmentOffice setting, government or healthcare organizationHealthcare provider offices, billing departments
Employer & Industry UsageUsed by Medicare administrative contractors, healthcare organizationsUsed by hospitals, clinics, insurance companies
Search & Comparison IntentUnderstanding roles related to Medicare enrollment processesUnderstanding claims processing and billing procedures

The Medicare Provider Enrollment Analyst primarily focuses on enrolling providers into Medicare, ensuring compliance with policies. In contrast, the Medicare Claims Specialist handles claims processing, billing, and reimbursement. Both roles require healthcare knowledge but serve different functions within the Medicare ecosystem.

How to become a Medicare Provider Enrollment Analyst?

To become a Medicare Provider Enrollment Analyst, candidates typically need a bachelor's degree in healthcare administration, health information management, or a related field. Relevant experience in healthcare compliance, knowledge of Medicare policies, and proficiency with enrollment systems like PECOS are also important; certifications such as the Certified Provider Enrollment Specialist (CPES) can enhance prospects.
More about Medicare Provider Enrollment Analyst jobs

What are the most commonly searched types of Medicare Provider Enrollment Analyst jobs?

The most popular types of Medicare Provider Enrollment Analyst jobs are:

What job categories do people searching Medicare Provider Enrollment Analyst jobs look for?

The top searched job categories for Medicare Provider Enrollment Analyst jobs are:

Medicare Provider Enrollment Analyst jobs near you
Infographic showing various Medicare Provider Enrollment Analyst job openings in the United States as of August 2026, with employment types broken down into 1% Locum Tenens, 2% As Needed, 76% Full Time, 16% Part Time, and 5% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $49,501 per year, or $23.8 per hour.

Provider Enrollment Specialist

AMERICAN ADVANCED MANAGEMENT

Salida, CA • On-site

$22 - $26/hr

Full-time

Re-posted 11 days ago

Job description

Description

The Provider Enrollment Specialist role involves managing the administrative process of getting healthcare providers credentialed with insurance companies and government payers like Medicare and Medicaid. Key duties include preparing and submitting applications, tracking their status, maintaining accurate provider records, ensuring compliance with regulations, and following up with providers and payers to resolve issues. 


JOB DUTIES

  • Prepare and submit enrollment applications and supporting documents for new and existing providers.
  • Maintain and update provider information in databases and systems, ensuring accuracy of details like licenses, certifications, and addresses. 
  • Verify provider credentials and ensure all paperwork meets the requirements of various health plans and government payers.
  • Act as a liaison by responding to inquiries from providers and payers, and follow up to expedite the enrollment and re-enrollment process.
  • Research and resolve issues that delay enrollment, such as missing information on applications.
  • Organize and maintain files for all provider enrollments and other related documentation. 


Requirements

The Provider Enrollment Specialist will possess a strong understanding of healthcare regulations, payer requirements, and provider enrollment processes, along with familiarity with medical terminology and basic billing practices. Technical proficiency is essential, including experience with provider enrollment software, credentialing databases such as CAQH, and common office applications like Word and Excel. Success in this role requires excellent attention to detail, strong organizational skills, and effective communication to manage complex documentation and coordinate with multiple stakeholders. Prior experience in a healthcare setting with at least three (3) to five (5) years of experience is preferred, particularly in credentialing, managed care, or claims processing.

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