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The Lead Enrollment Specialist manages complex commercial and government payor enrollment functions while providing functional leadership and coordination for the enrollment team. This role ensures the accuracy and timeliness of provider and facility registrations to support revenue cycle integrity and mitigate reimbursement risks.
JOB SUMMARY
The Lead Enrollment Specialist serves as the senior technical and operational expert within Enrollment Services responsible for performing complex commercial and government payor enrollment functions—the processes required to register providers and facilities with insurance payors so they can be authorized to bill and receive reimbursement—while providing day-to-day functional leadership, coordination, and support for Enrollment Specialists.
This role has primary responsibility for the ownership, coordination, and execution of non-professional/facility and provider enrollment activities across the system, in addition to managing advanced and escalated provider enrollment issues. The Lead Enrollment Specialist ensures accuracy, consistency, and timeliness of enrollment processes to support revenue cycle integrity, reduce delays in billing readiness, and mitigate reimbursement risk.
The Lead Enrollment Specialist serves as a key subject matter expert and resource for the team, providing training, mentorship, and quality oversight. In partnership with the System Manager of Enrollment Services, this role supports implementation of standardized workflows, monitors performance trends, and contributes to continuous process improvement initiatives. The position functions as a critical liaison between enrollment operations, revenue cycle, contracting, and operational stakeholders across the system.
EDUCATION
Associate’s degree or equivalent experience required
Bachelor’s degree preferred
CPES or similar certification preferred
EXPERIENCE
Minimum 4–5 years of provider enrollment experience (required)
Demonstrated experience independently managing complex or escalated enrollment issues (required)
Experience serving as a subject matter expert in PECOS facility/non-facility enrollment. (required)
Experience serving as a subject matter expert, trainer, or lead resource (strongly preferred)
Direct experience with non-professional/facility enrollment (strongly preferred)
Experience coordinating system-level or multi-entity enrollment activities (strongly preferred)
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