We are seeking an experienced Enrollment Specialist to manage payer enrollment activities across multiple lines of business, including Medicaid (Georgia), Medicare, Tricare, and Molina. This role is responsible for end-to-end provider enrollment, revalidation, and maintenance, ensuring timely and accurate submissions while maintaining compliance with payer and regulatory requirements. The ideal candidate is a self-starter who can work independently, navigate payer portals efficiently, and manage a high-volume workload with minimal supervision.
Key Responsibilities:
Manage full-cycle provider enrollment and revalidation processes for Medicaid (Georgia), Medicare, Tricare, and Molina
Prepare, submit, and track enrollment applications through various payer portals and systems
Maintain accurate and up-to-date provider records in internal databases and payer systems
Monitor application status, follow up with payers, and resolve enrollment issues or delays proactively
Ensure compliance with all federal, state, and payer-specific requirements and timelines
Collaborate with internal teams (credentialing, operations, contracting) to ensure alignment and timely onboarding
Identify process gaps and recommend workflow improvements to enhance efficiency and turnaround times
Maintain detailed documentation and reporting on enrollment status and key metrics
Stay current on payer requirements, portal updates, and regulatory changes
Qualifications:
Minimum of 5 years of experience in provider enrollment
Hands-on experience with Medicaid (Georgia), Medicare, Tricare, and Molina enrollment processes
Strong working knowledge of payer portals and enrollment platforms (e.g., PECOS, state Medicaid portals, Tricare, etc.)
Proven ability to manage multiple enrollments across locations and providers simultaneously
Experience working in a high-volume, deadline-driven environment
High level of accuracy and attention to detail
Skills & Competencies:
Self-motivated with the ability to work independently and prioritize workload effectively
Strong problem-solving skills and ability to navigate complex enrollment issues
Excellent organizational and time management skills
Clear and professional communication skills, both written and verbal
Ability to adapt to changing processes and evolving payer requirements
Proficiency in Microsoft Office and enrollment/credentialing systems
Preferred Qualifications:
Experience supporting multi-state or multi-site healthcare organizations
Experience with credentialing databases (e.g., MD-Staff, CAQH, or similar systems)
Founded in 2011 as an independent Urgent Care operator in Atlanta, Georgia, WellStreet quickly grew into a network of 7 locations within one year of operations. In 2014, our partnership model emerged as we partnered with Piedmont Healthcare to grow and expand the Piedmont Urgent Care brand across North Georgia. Our story continued in 2019, as we launched a partnership with Corewell Health, to deploy and operate a network of urgent cares under the Corewell Health Urgent Care brand in Southeastern Michigan.
WellStreet’s market footprint has continued evolving as additional partnerships launched in early 2023 with University Hospitals and Prisma Health. Despite our rapid growth, our teammates and leaders remain steadfast in our commitment to providing each and every patient with best-in-class quality and experience as we continue evolving to meet the patient needs of tomorrow!
Uncompromising Care…One Patient at a Time
