Sr. Provider Enrollment Specialist, Fully Remote

Centauri Health Solutions provides technology and technology-enabled services to payors and providers across all healthcare programs, including Medicare, Medicaid, Commercial and Exchange. In partnership with our clients, we improve the lives and health outcomes of the members and patients we touch through compassionate outreach, sophisticated analytics, clinical data exchange capabilities, and data-driven solutions. Our solutions directly address complex problems such as uncompensated care within health systems; appropriate, risk-adjusted revenue for specialized sub-populations; and improve access to and quality of care measurement. Headquartered in Scottsdale, Ariz., Centauri Health Solutions employs 1700 dedicated associates across the country. Centauri has made the prestigious Inc. 5000 list since 2019, as well as the 2020 Deloitte Technology Fast 500 list of the fastest-growing companies in the U.S. For more information, visit

Role Summary
The Out of State "OOS" Medicaid division of Centauri Health Solutions works with hospitals and health systems across the United States to handle billing and enrollment of their Out of State Medicaid claims. The core work of our "OOS" division can be summarized as hospital billing, hospital and physician enrollment, and eligibility verifications.

Team members within the Senior Provider Enrollment Specialist role are assigned, by client, to work with Medicaid payers in all states and oversee the provider enrollment process. As a Senior PE Specialist this individual must be knowledgeable in the enrollment process and focuses on client management and communications. This is a client facing role that requires a lot of attention to detail and follow through. The Senior Provider Enrollment Specialist is the point of contact for all enrollment related questions and issues for both clients and internal staff.

Role Responsibilities
The following responsibilities are assigned to staff based on experience, skill set, and company needs:

• Complete Training Plan

• Advanced knowledge of Out of State Medicaid enrollment; individuals moved into this position are promoted internally based on their expert knowledge in provider enrollment

• Employees must complete a 90-day training plan to master role responsibilities

• Accounts are audited until training plan is completed
• Utilize internal user procedures

• Knowledge of Out of State Medicaid payer guidelines

• Management of assigned task listing

• Review all assigned tasks and complete by the set follow up date

• Review accounts in a timely manner consistent with identified procedures

• Prioritize workload based on follow up date, dollar amount, and/or filing limits
• Document findings and status within the system
• Identify Payor trends and submit the necessary system updates
• Upload supporting documentation to the system
• Work together within assigned groups to determine next steps

• Utilize multiple systems to determine enrollment requirements and verify provider demographic information with the payor

• Provider Enrollment Point of Contact for Out of State Division

• Point of contact for all client related questions or issues

• Manage enrollment requests for their assigned client alpha

• Communication with clients on a daily, weekly and/or monthly basis to request and follow up on enrollment requests to obtain the necessary information to proceed the enrollment process

• Coordinate and/or participate in conference calls with clients to discuss outstanding enrollment requests

• Prepare support data for all conference calls and/or communications including Provider Enrollment Report to itemize requests pending for enrollment

• Audit accounts for assigned client alpha to ensure Provider Enrollment team is following company, department, and client guidelines for enrollment

• Engages in client relationship building and client satisfaction

• Establish new client profile for provider enrollment; gather client demographic information, credentials, personal information guidelines, follow up guidelines, and any other client preferences for enrollment requests
• Initiates and builds effective relationships with the provider enrollment contacts at the client level
• Serves as the official interface between the client and the Out of State division for all enrollment related questions and requests
• Answers client questions and addresses servicing concerns through resolution
• Works to ensure success in achieving project goals and in meeting client expectations
• Interacts with client in a productive, cooperative manner
• Client Data Management
• Maintain client demographic information and credential
• Client noting for enrollment preferences; personal information requirements, physician enrollments, enrollment thresholds, and preferred client follow up method
• Annual check in with client to review enrollment preferences for any potential changes and enrollment trends to improve the existing process
• Manage and oversee special projects as related to client changes in demographic information

Role Requirements

• Experience with Provider Enrollment and/or Credentialing
• Candidates reviewed for the Senior Provider Enrollment Specialist position must have a minimum of 6 months to 1 year experience within the organization in the Provider Enrollment Specialist role
• Knowledge of Out of State Medicaid payer guidelines
• One year of administrative experience
• Ability to lead and direct others
• Excellent Written and Verbal Communication skills
• Excellent interpersonal skills
• Advanced skills in Windows and MS Office applications
• Excellent organizational skills
• Excellent customer service skills
• Excellent client relations skills
• Excellent Interpersonal skills
• Excellent problem-solving/decision-making

We believe strongly in providing employees a rewarding work environment in which to grow, excel and achieve personal as well as professional goals. We offer our employees competitive compensation and a comprehensive benefits package that includes generous paid time off, a matching 401(k) program, tuition reimbursement, annual salary reviews, a comprehensive health plan, the opportunity to participate in volunteer activities on company time, and development opportunities. This position is bonus eligible in accordance with the terms of the Company's plan.

Centauri currently maintains a policy that requires several in-person and hybrid office workers to be fully vaccinated. New employees in the mentioned categories may require proof of vaccination by their start date. The Company is an equal opportunity employer and will provide reasonable accommodation to those unable to be vaccinated where it is not an undue hardship to the company to do so as provided under federal, state, and local law.

Factors which may affect starting pay within this range may include geography/market, skills, education, experience and other qualifications of the successful candidate.

This position is bonus eligible in accordance with the terms of the Company's plan.