Payer Enrollment Specialist

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

📋 Description

• Complete and oversee payer applications for both initial enrollment and re-enrollment processes.

• Ensure adherence to organizational policies and regulatory mandates.

• Collaborate with insurance payers to keep precise provider enrollment records for both government and commercial entities.

• Create and distribute monthly delegated provider rosters.

• Work alongside the medical credentialing team regarding provider enrollments and terminations.

• Act as a primary contact for inquiries and issues related to payer enrollment.

• Identify and address enrollment-related challenges with insurance payers.

• Enter, maintain, and update provider data in payer enrollment systems.

• Utilize MD-Staff or similar software to monitor application statuses and follow up on outstanding requests.

• Update tracking spreadsheets and present enrollment reports to leadership and stakeholders.

• Ensure that active providers are enrolled with the appropriate payers.

• Submit prompt updates for provider terminations and other modifications.

• Generate reports detailing enrollment progress, compliance, and updates to delegated rosters.

• Suggest process enhancements and fulfill assigned responsibilities to support payer enrollment operations.

⛳️ Requirements

• High School Diploma/GED or 3 years of relevant equivalent experience in place of a Diploma/GED.

• 1-3+ years of experience in an office, business, operations, customer service, or healthcare environment.

• Operational experience with MD-Staff or other software for payer enrollment.

• Experience managing delegated rosters for insurance payers.

• Travel may be necessary: Up to 10%.

• Clearance requirement: None.

🏝️ Benefits

• Medical, Rx, Dental & Vision Insurance.

• Personal and Family Sick Time & Company Paid Holidays.

• Position may qualify for a discretionary variable incentive bonus.

• Parental Leave.

• 401(k) Retirement Plan.

• Basic Life & Supplemental Life Insurance.

• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts.

• Short-Term & Long-Term Disability coverage.

• Tuition Reimbursement, Personal Development & Learning Opportunities.

• Skills Development & Certifications.

• Employee Referral Program.

• Corporate Sponsored Events & Community Outreach initiatives.

• Emergency Back-Up Childcare Program.

• Flexible benefits package.