Sample Provider Enrollment Specialist Resume

Posted in Specialist Resume Examples

Brian Smith
4303 Oakwood Avenue
New York, NY 10011

Job Objective To work as a Provider Enrollment Specialist for the right company seeking dependable employees. Looking to use my past skills and experience in the specialist field in order to help the company advance.

Highlights of Qualifications:

  • Hand on experience in managing projects and people associated with same
  • Outstanding knowledge of insurance regulations and contract policies
  • Huge knowledge of QNXT operating system
  • Immense ability to interact with various individuals professionally
  • Sound ability to manage multiple tasks and prioritized work
  • Exceptional communication skills in both oral and written forms
  • Skilled to work on personal computers and windows
  • Excellent skills to manage production standards and timelines
  • Proficient in maintaining accuracy in process.

Professional Experience:

Provider Enrollment Specialist
Neighborhood Health Plan (NHP), New York, NY
May 2006 – Present

  • Administered all provider enrollment transactions and managed new provider affiliations and terminations.
  • Provided support to various enrollment transactions and ensure completion according to time standards.
  • Coordinated with member services and configuration team and processed all enrollment transactions.
  • Monitored enrollment issues and resolved it to track progress of transactions.
  • Prepared a provider status list and prepared status lists to be presented to groups.
  • Managed and answered all questions from staff and provided status reports of all enrollment transactions.
  • Ensured maintenance of data quality standards for data entry of provider transactions.
  • Collaborated all receipts and responded to all letter of interest.

Provider Enrollment Specialist
Anesthesia Business Consultants, LLC, New York, NY
March 2003 – April 2006

  • Provided enrollment facilities for clients and managed transition for new clients.
  • Assisted and checked credentials in making all initial appointments and reappointments.
  • Ensured compliance to all Federal and Medical aid programs for enrollment of new providers.
  • Maintained database and provided maintenance services to providers and groups.


Bachelor’s Degree in Healthcare Management
Albertus Magnus College, New Haven, CT

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