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

📋 Description

• Ensure that all required documentation (licenses, contracts, tax information, etc.) is submitted to payors and remains up to date to satisfy enrollment and revalidation criteria.

• Serve as the primary contact for addressing enrollment challenges, including rejections, delays, or discrepancies, by liaising directly with payors.

• Oversee and track revalidation deadlines for providers to guarantee timely re-enrollment and avoid interruptions in reimbursement.

• Maintain comprehensive records and generate reports on the status of payor enrollments, encompassing completed, pending, and rejected submissions.

• Ensure the timely re-attestation of CAQH profiles.

• Exhibit regular and predictable attendance.

• Execute all other assigned responsibilities.

⛳️ Requirements

• A minimum of 1-3 years of experience in credentialing and payor enrollment, including the upkeep of in-network contracts/enrollments with both private and public payors.

• Proficient knowledge of State Medicaid, including Managed Medicaid Care Organizations, Medicare, commercial/private health plans, and insurance carriers.

• Familiarity with the PECOS system.

• Experience collaborating with major payors such as UnitedHealthcare, Aetna, Cigna, and Blue Cross Blue Shield.

• Strong attention to detail and precision.

• Exceptional organizational and prioritization abilities.

• Team-oriented with a collaborative approach.

• Open to feedback and committed to continuous improvement.

• Certification in payer enrollment, healthcare administration, or a related field is advantageous.

• Preference for candidates with experience working from home.

• Reliable access to a private workspace equipped with high-speed internet and a professionally suitable environment for frequent video conferencing.

• Workstation setup that accommodates remote work requirements.