Rural Physicians Group is an expansive physician network of rural-focused hospitalists, surgicalists, and APPs that are passionate about helping rural hospitals meet the needs of the communities we serve.  By working with Rural Physicians Group, our hospital partners receive full-time dedicated providers on site, filling a critical void in care coverage and allowing for better patient outcomes.  Better outcomes lead to expanded inpatient services. Expanded inpatient services revitalize the hospital.  And a revitalized hospital improves the entire community.

RPG’s mission is, “Bringing rural hospitals and providers together to enhance the care of their community.”

 

We are seeking a detail-oriented and highly organized Provider Enrollment Specialist to support our mission by ensuring timely and compliant enrollment of providers across all contracted payors. 

 

Position Summary

The Provider Enrollment Specialist is responsible for the end-to-end management of provider enrollment activities, including application submission, revalidation, maintenance, and issue resolution for individual providers, group enrollments, and new practice locations.

This role ensures regulatory compliance, mitigates reimbursement risk, and maintains uninterrupted billing capability across all payor contracts.

 

Essential Duties: May be required to do one or all of the following dependent on the business needs (including but not limited to):

 

Enrollment & Application Management

• Prepare, complete, and submit enrollment and revalidation applications for Medicare, Medicaid (in-state and out-of-state), MCOs, and commercial payors
• Manage both individual and group enrollments, including new TINs and new service locations
• Coordinate Medicare Part A, Part B, and facility alignments as applicable
• Monitor application status and conduct routine follow-ups to prevent enrollment delays

CAQH & Credentialing Support

• Maintain and attest CAQH profiles for all assigned providers
• Ensure documentation accuracy (licenses, DEA, board certifications, malpractice coverage, W-9s, etc.)
• Support delegated credentialing processes as required

Compliance & Risk Mitigation

• Maintain tracking systems to prevent lapses in enrollment or billing eligibility
• Monitor payor revalidation cycles and proactively initiate renewals
• Ensure compliance with federal, state, and payor-specific regulations
• Safeguard confidential provider and organizational information in accordance with HIPAA and company policy

Contract & Operational Coordination

• Track enrollment status in alignment with executed payor contracts
• Assist in onboarding new providers and expanding services to new hospital partners
• Collaborate with Contracting, Credentialing, Revenue Cycle, and Hospital Leadership teams

Issue Resolution & Communication

• Respond to payor correspondence and provider inquiries in a timely and professional manner
• Escalate complex enrollment issues appropriately
• Effectively manage escalated conversations with diplomacy and professionalism

Reporting & Process Improvement

• Maintain accurate enrollment logs and dashboards
• Support leadership reporting related to enrollment timelines and risk exposure
• Identify workflow improvements to enhance efficiency and compliance

Additional Duties

• Perform other duties as assigned to support departmental and organizational goals

 

Skills and Qualifications:

• Minimum 2 years of Provider Enrollment experience in a healthcare setting
• Strong working knowledge of Medicare, Medicaid, and commercial payor enrollment processes
• Experience managing CAQH profiles and payor portals
• High attention to detail and strong organizational skills
• Ability to prioritize workload in a fast-paced, evolving environment
• Strong analytical and problem-solving abilities
• Excellent written and verbal communication skills
• Ability to work independently and collaboratively across departments
• Proficiency in Microsoft Excel and provider tracking systems
• Associate’s degree or relevant certification preferred
• Bachelor’s degree in Business, Healthcare Administration, or related field preferred

 

Benefits:

• Competitive salary
• Incentivized bonus plan
• Ability to work remotely from home 
• Three weeks of paid time off, accrual starting first day
• Comprehensive medical, dental, and vision insurance plans
• 401(k) with company match
• Health Savings Account
• Basic Life Insurance coverage
• Cell Phone Allowance

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