[Hiring] Managed Care Enrollment Specialist I @Brightli

Role Description

Bring your professional administrative experience, attention to detail, and ability to manage complex information to a remote role that helps healthcare providers remain enrolled and ready to deliver care. As a Managed Care Enrollment Specialist I , you’ll:

• Complete provider enrollment and revalidation applications, maintain accurate payer records, monitor deadlines, and help resolve issues that could affect reimbursement or access to healthcare services.

Qualifications

• Required: Professional experience in an administrative, office, data-management, insurance, billing, claims, healthcare, financial, or similarly detail-focused business environment.
• Strongly Preferred: Healthcare revenue cycle experience, including patient billing, insurance claims, collections, or reimbursement.
• Preferred: Provider enrollment, payer enrollment, managed care, or credentialing experience.

Requirements

• High school diploma, GED, or equivalent.
• Professional experience in an administrative, office, data-management, insurance, billing, claims, healthcare, financial-services, or similarly detail-focused business environment.
• Experience maintaining accurate records, processing detailed information, and meeting established deadlines.
• Professional experience using Microsoft Office applications, including Microsoft Excel.
• Ability to work independently in a remote environment with reliable organization, time management, and follow-through.
• Preferred: Healthcare revenue cycle experience, including patient billing, insurance claims, collections, payment processing, reimbursement, or related payer functions.
• Experience with provider enrollment, payer enrollment, managed care, provider credentialing, privileging, or revalidation.
• Experience communicating with commercial insurance carriers, Medicaid, Medicare, managed care organizations, or other healthcare payers.
• Advanced Microsoft Excel experience, including sorting, filtering, formulas, data validation, and tracking large amounts of information.
• Experience working remotely in healthcare administration, revenue cycle, insurance, credentialing, or provider support.

Benefits

• A robust full-time employee benefits package encompassing health, dental, vision, retirement, disability, life insurance, wellness program, generous paid time off, and more.
• Telemedicine – 24/7 phone, web, or mobile app medical, behavioral health, & dermatology visits.
• Employee Assistance Program – 24/7 counseling services, legal assistance, & financial consultation for you and your household at no cost.
• Career Advancement & Wage Growth - Grow in your career with great opportunities for upward mobility and added income.
• Comprehensive Training - Learn and develop skills with our robust on-the-job training.
• Workplace Culture - An environment cultivating employee wellbeing, valuing each individual's humanity, and actively promoting healthy, joyful workforce engagement.
• Remote Work Opportunity - Enjoy the flexibility and comfort of working from home.

Key Responsibilities

• Complete initial provider enrollment, payer enrollment, and revalidation applications accurately and within required deadlines.
• Maintain complete provider records, credentials, practice locations, services, payer data, and application statuses.
• Coordinate with providers and internal teams to obtain required documentation, verify information, resolve discrepancies, and communicate updates.
• Monitor enrollment applications and outstanding items to support timely payer approval and minimize reimbursement delays.
• Audit payer records and provider data to identify errors, maintain compliance, and protect data integrity.
• Prepare managed care reports, tracking tools, enrollment documentation, and status updates using Microsoft Excel and other business systems.
• Serve as a liaison for external privileging, payer requests, and contractual enrollment requirements.
• Research payer policies, enrollment requirements, and industry updates and translate findings into clear next steps.
• Collaborate with Managed Care, Credentialing, Revenue Cycle, Operations, and other teams to improve provider enrollment processes.

Additional Qualifications

• Exceptional organization, accuracy, follow-through, and attention to detail.
• Strong written and verbal communication and customer-service skills.
• Ability to research payer policies and convert complex requirements into actionable steps.
• Ability to manage multiple applications, projects, deadlines, and stakeholder requests simultaneously.
• Strong analytical, auditing, problem-solving, and process-improvement skills.
• Ability to protect confidential provider, organizational, and healthcare information.
• Reliable professional workspace and ability to collaborate effectively in a remote work environment.

Physical Requirements

• Perform primarily sedentary work in a remote environment involving extended periods of sitting and computer use.
• Frequently use hands, fingers, and arms for typing, data entry, reporting, and electronic communication.
• Occasionally stand, walk, or move materials weighing up to 10 pounds.
• Perform the essential functions of the position with or without reasonable accommodation.