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, Medicaid, and Medicare health plans while maintaining accurate provider records and collaborating with the credentialing team.

Key responsibilities

• Enrolls new providers with commercial health plans, Medicaid, and Medicare
• Maintains provider enrollment status in the credentialing system and ensures data accuracy
• Follows up with health plans until providers are fully enrolled and escalates issues as necessary

Required qualifications

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