Payer Fee Schedule Specialist

This is a fully remote position, open to applicants in California, +10 more states.

📋 Description

• Submit requests for fee schedules to Medicare, Medicaid, and commercial payers (such as BCBS, UHC, Aetna, Cigna) across multiple states, including NY, NJ, CA, TX, FL, PA, CO, WI, WA, MD, and MO.

• Consistently follow up with payer representatives via phone and email to secure written confirmations of rates and to address any information gaps.

• Ensure all requests are accompanied by the correct CPT codes, provider NPIs, tax IDs, and any additional identifiers required by payers to facilitate accurate and timely retrieval of fee schedules.

• Maintain detailed and precise status updates in our tracking systems in real-time, ensuring the internal team has up-to-date visibility.

• Clearly identify and flag discrepancies, missing rates, or any unusual findings, providing sufficient context for the team to take appropriate action.

• Work collaboratively with credentialing and billing team members to prioritize requests and escalate any stalled items.

⛳️ Requirements

• A minimum of 2 years of direct experience in payer enrollment, credentialing, or revenue cycle operations, specifically related to fee schedule requests.

• Proven experience collaborating with health plans in NY, NJ, CA, TX, FL, PA, CO, WI, WA, MD, and/or MO — please specify the payers in your application.

• Excellent oral communication skills for engaging in payer phone conversations; adept at navigating automated systems and connecting with live representatives.

• Strong written communication capabilities to craft follow-up emails and log internal status updates — your notes should be clear and self-explanatory.

• Exceptional attention to detail, particularly concerning CPT code sets and payer-specific data requirements.

• Proficiency with credentialing databases, spreadsheets, and document management software.

🏝️ Benefits

• Flexible working hours with a consistent weekly workload.

• Opportunities for growth into expanded operations or enrollment roles as the team develops.