Senior Provider Enrollment Specialist

A5 Healthcare (Anders Affiliate) one of one of the fastest-growing Credentialing Verification Organizations in the country is seeking a Senior Provider Enrollment Specialist who is motivated to learn, excited to collaborate and passionate about delivering outstanding results. This individual will have a direct impact on our firm’s mission of serving as a catalyst for those striving to achieve their highest potential. 

The Senior Provider Enrollment Specialist at A5 Services serves as a key leader in the credentialing and payer enrollment function for the Independent Physician Association (IPA). This advanced role is responsible for overseeing and executing complex enrollment processes, ensuring compliance with NCQA, URAC, and CMS accreditation standards, and providing mentorship and guidance to junior staff. The Senior Specialist acts as a subject matter expert and strategic partner across departments and with external payers to streamline and enhance the credentialing workflow. This position plays a critical role in maintaining operational excellence, regulatory compliance, and provider satisfaction.

What You’ll Do:  

Advanced Provider Enrollment and Credentialing 

• Lead the submission and oversight of complex and high-priority initial applications, reappointments, and recredentialing efforts.
• Conduct quality assurance reviews of credentialing documents and workflows to ensure accuracy and compliance.
• Serve as the primary liaison with health plans on escalated or time-sensitive enrollment matters.
• Oversee and improve payer tracking systems and credentialing databases; ensure all data is accurately maintained.
• Identify and address systemic issues in enrollment processes, recommending and implementing best practices.
• Support audits and accreditation activities by compiling data and documentation as needed.
• Assist leadership in developing policies and procedures for credentialing and payer enrollment functions.

Team Support and Leadership

• Provide mentorship and training to Payer Enrollment Specialists and new team members.
• Support team workload balancing by assisting in complex case management and troubleshooting.
• Collaborate cross-functionally with internal stakeholders such as compliance, provider relations, and operations.
• Represent the credentialing team in interdepartmental meetings and projects.

General Responsibilities

• Maintain in-depth knowledge of evolving payer policies, credentialing regulations, and accreditation standards.
• Analyze data and produce reports on credentialing metrics and trends.
• Participate in continuous improvement initiatives and credentialing software optimization.
• Promote a collaborative, high-performance culture in a fully remote or hybrid team environment.

What We’re Looking For:   

• Proven leadership ability and experience mentoring or training junior staff.
• Advanced understanding of credentialing workflows, payer enrollment requirements, and regulatory compliance.
• High-level organizational and problem-solving skills with keen attention to detail.
• Excellent written and verbal communication; capable of handling sensitive issues with professionalism.
• Proficient in credentialing and enrollment systems, with strong Excel and Microsoft Office Suite skills.
• Self-directed, accountable, and capable of managing priorities in a fast-paced remote environment.

Your Qualifications:  

• Associate’s degree required; Bachelor’s degree in healthcare administration or a related field preferred.
• Minimum 3–5 years of experience in payer enrollment or healthcare credentialing, including experience with NCQA, URAC, and CMS standards.
• Certification as a Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medical Services Management (CPMSM) is strongly preferred.

Applicants to the Senior Provider Enrollment Specialist position must be located within the Tulsa, OK area.