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

• Enrolls new providers with all relevant commercial health plans, Medicaid, and Medicare
• Maintains and updates provider enrollment status in the credentialing system, CredentialStream
• Collaborates with the credentialing team and follows up with health plans until providers are approved for participation

Required qualifications

• 2+ years of experience in payer enrollment functions
• Experience with various payer portals is required
• Medicare and Medicaid payer experience is mandatory
• Familiarity with Verity CredentialStream or other credentialing software is preferred
• Experience in revenue cycle management (RCM) and enrollment claim resolution is preferred