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Provider Enrollment Jobs in Arizona (NOW HIRING)

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Provider Enrollment information

What is provider enrollment?

Provider enrollment is the process by which healthcare professionals and organizations apply to participate in health insurance networks, including Medicare, Medicaid, and private insurance plans. This involves submitting detailed information about credentials, licenses, and practice details to insurance payers for approval. Successful enrollment allows providers to bill insurance companies and receive reimbursement for services rendered to insured patients. The process ensures that only qualified and authorized providers deliver care to covered individuals.

What are the key skills and qualifications needed to thrive as a provider enrollment specialist?

To thrive as a Provider Enrollment Specialist, you need strong organizational skills, attention to detail, and knowledge of healthcare regulations, often supported by a background in healthcare administration or a related field. Familiarity with provider enrollment software, credentialing databases, and proficiency in using systems like CAQH and Medicare/Medicaid portals are typically required. Excellent communication, problem-solving abilities, and the capacity to manage multiple tasks efficiently are vital soft skills for this role. These competencies ensure timely and accurate provider onboarding, compliance with regulatory requirements, and effective coordination between healthcare providers and payers.

What are some typical challenges faced in a provider enrollment role, and how can they be managed effectively?

Professionals in Provider Enrollment often encounter challenges such as navigating complex and varying payer requirements, handling time-sensitive documentation, and managing communication between providers and insurance companies. Staying organized and proactive in tracking application statuses, maintaining up-to-date knowledge of payer guidelines, and fostering strong relationships with both internal teams and external contacts are key strategies for overcoming these hurdles. Using workflow management tools and regularly attending industry training can also help streamline the enrollment process and reduce delays.

What is the difference between Provider Enrollment vs Provider Credentialing?

AspectProvider EnrollmentProvider Credentialing
Required CredentialsLicenses, certifications, provider numbersLicenses, certifications, education verification
Work EnvironmentHealthcare administration, insurance companiesHealthcare facilities, insurance panels
Employer & Industry UsageInsurance plans, government programsHospitals, clinics, insurance panels
Search & Comparison IntentHow to enroll as a providerHow to verify provider qualifications

Provider Enrollment involves registering with insurance companies and government programs to become an approved healthcare provider. Provider Credentialing focuses on verifying a provider's qualifications, licenses, and certifications to ensure they meet industry standards. While both are essential for practicing in healthcare, enrollment is about gaining access, and credentialing is about verifying qualifications.

What are the most commonly searched types of Provider Enrollment jobs in Arizona?

The most popular types of Provider Enrollment jobs in Arizona are:

What are popular job titles related to Provider Enrollment jobs in Arizona?

For Provider Enrollment jobs in Arizona, the most frequently searched job titles are:

What job categories do people searching Provider Enrollment jobs in Arizona look for?

The top searched job categories for Provider Enrollment jobs in Arizona are:

What cities in Arizona are hiring for Provider Enrollment jobs?

Cities in Arizona with the most Provider Enrollment job openings:

Provider Enrollment jobs near you
Infographic showing various Provider Enrollment job openings in Arizona as of August 2026, with employment types broken down into 2% Internship, 67% Full Time, and 31% Part Time. Highlights an 85% In-person, and 15% Remote job distribution.

Provider Enrollment Specialist

American Vision Partners

Tempe, AZ

Full-time

Re-posted 25 days ago

American Vision Partners rating

6.3

Company rating: 6.3 out of 10

Based on 29 frontline employees who took The Breakroom Quiz

Job description

Overview

As a Provider Enrollment Specialist, you'll be responsible for assisting with the administration of the provider enrollment process for assigned new and existing providers. You'll also be responsible for assisting in obtaining and maintaining information essential to complete the credentialing/re-credentialing process.

Responsibilities

  • Prepares and submits enrollment applications for practitioners/group practices and facilities
  • Initiates and manages new enrollments until providers are enrolled with all assigned payers
  • Follows up on the status of enrollment applications as well as maintaining all updated needed using Smart Sheets
  • Using Smart Sheets, keeps detailed log of all pending and completed tasks
  • Maintains/Updates/Communicates enrollment status reports and updates on regular basis
  • Maintains/updates Wybtrak/CAQH and other provider portals on regular basis
  • Maintains managed care insurance paperless files for assigned practitioners
  • Frequently contacts practitioners, insurance representatives and other provider staff for compilation of provider data
  • Complies with NCQA, Medicare and Medicaid standards, department procedures and guidelines
  • Maintains strict confidentiality, adheres to all HIPAA Guidelines/Regulations
  • Familiar with Medicare, Medicaid, commercial fee schedules; assist Director in updating fee schedules for updates to Next Gen EPM
  • Works effectively and proactively to resolve issues
  • Performs all other duties as assigned

Qualifications

  • High School Diploma or equivalent
  • Associate's Degree preferred or - 2 years of office business experience in lieu of Associate Degree
  • Provider Enrollment Specialist Certificate (PESC) or Certified Provider Credentialing Specialist (CPCS) or similar certification in credentialing, health plan or network management required

  • 2 – 3 years’ experience in Provider Enrollment and Credentialing fields is required for this position

  • Must have working knowledge in Managed Care and/or Network Management

  • Proficiency in MS applications including and not limited to credentialing database software
  • Strong organizational skills and ability to pay attention to detail
  • Excellent communication skills and problem solving abilities within a team environment
  • Ability to work independently and prioritize assigned duties within given time frames
  • Ability to establish and maintain effective working relationships with insurance representatives, providers and coworkers

What American Vision Partners employees say

Pay

Benefits

Hours and flexibility

Workplace

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