Payer Enrollment Specialist

Job Summary

Managing the payer enrollment process, the full-time Payer Enrollment Specialist will serve as the primary contact for independent providers, enrolling them with commercial health plans, Medicaid, and Medicare while maintaining accurate provider records.

Key responsibilities

• Enroll providers with commercial health plans, Medicaid, and Medicare
• Update and maintain provider enrollment status in the credentialing system
• Collaborate with the credentialing team and follow up with health plans until providers are PAR

Required qualifications

• 2+ years of experience in payer enrollment function
• Experience working in various payer portals
• Medicare/Medicaid payer experience required
• Experience with RCM - enrollment claim resolution preferred
• Familiarity with Verity CredentialStream or other credentialing software preferred