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.

• Ensure adherence to organizational standards as well as regulatory regulations.

• Collaborate with insurance payers to ensure that provider enrollment records for government and commercial payers are accurate.

• Create and distribute monthly delegated provider rosters.

• Work in conjunction with the medical credentialing team on provider enrollments and terminations.

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

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

• Input, maintain, and update provider information within payer enrollment systems.

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

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

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

• Submit prompt updates regarding provider terminations and other modifications.

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

• Suggest process enhancements and carry out assigned responsibilities that support payer enrollment operations.

⛳️ Requirements

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

• 1-3+ years of experience in office management, business operations, customer service, or the healthcare sector.

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

• Familiarity with managing delegated rosters for insurance payers.

🏝️ Benefits

• Medical, Rx, Dental & Vision Insurance.

• Personal and Family Sick Time & Company Paid Holidays.

• Position may be eligible 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.

• Tuition Reimbursement, Personal Development & Learning Opportunities.

• Skills Development & Certifications.

• Employee Referral Program.

• Corporate Sponsored Events & Community Outreach.

• Emergency Back-Up Childcare Program.

• Flexible benefits package.