Account Representative, Provider Enrollment – payer portals exp. req.

This is a fully remote position, open to applicants in United States.

📋 Description

• Serve as the main point of contact for designated accounts across various states

• Effectively manage the complete credentialing and provider enrollment process independently

• Complete and monitor provider enrollment applications with commercial and managed care payers

• Maintain and update payer portals to guarantee accuracy and timely execution of contracts

• Oversee contracting processes with payers, addressing issues and escalating delays as necessary

• Assist with Medicare and Medicaid enrollments

• Navigate state-specific procedures unique to each payer and state

• Communicate with both payers and providers to fulfill enrollment and contracting requirements

• Keep clients updated through regular progress meetings and proactive problem-solving

• Ensure the accuracy of provider data, including maintaining up-to-date CAQH profiles

⛳️ Requirements

• Direct experience in provider enrollment is mandatory

• Experience in submitting individual enrollment applications for billable providers is essential

• Familiarity with payer portals for commercial, managed care, Medicare, and Medicaid is required

• Background in provider relations, payer contracting, or revenue cycle management is preferred

• Experience with nonprofit clinics, FQHCs, and/or private practices is necessary

• Proficiency in credentialing/enrollment software and Microsoft Excel is required

🏝️ Benefits

• Health Insurance

• 401k with matching contributions

• Paid Holidays

• Paid Time Off