| Remote Payer Enrollment Specialist
Remote Payer Enrollment Specialist |
Remote Payer Enrollment Specialist |
<p class="MsoNormal" style="margin-bottom:0in"><span style="font-family: Calibri, sans-serif; font-size: 11pt;">We are seeking a detail-orientedPayer Enrollment Specialist to manage provider enrollment and payer networkparticipation in a fully remote role. This position plays a critical role inensuring providers are properly credentialed and enrolled with commercial andgovernment payers, helping maintain compliance and protect reimbursement. Thespecialist will collaborate closely with internal teams, including AccountsReceivable (AR), to resolve credentialing issues, prevent enrollment-relateddenials, and support network expansion.</span></p><p class="MsoNormal" style="margin-bottom:0in"><span style="font-size:11.0pt;line-height:115%;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p><p class="MsoNormal" style="margin-bottom:0in"><b><span style="font-size:11.0pt;line-height:115%;font-family:"Calibri",sans-serif">Compensation:</span></b><span style="font-size:11.0pt;line-height:115%;font-family:"Calibri",sans-serif"> $20-$22 Per Hour<o:p></o:p></span></p><p class="MsoNormal" style="margin-bottom:0in"><span style="font-size:11.0pt;line-height:115%;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p><p class="MsoNormal" style="margin-bottom:0in"><b><span style="font-size:11.0pt;line-height:115%;font-family:"Calibri",sans-serif">Key Responsibilities<o:p></o:p></span></b></p><ul style="margin-top:0in" type="disc"> <li class="MsoNormal" style="margin-bottom:0in;mso-list:l0 level1 lfo1; tab-stops:list .5in"><span style="font-size:11.0pt;line-height:115%; font-family:"Calibri",sans-serif">Manage initial and ongoing provider enrollment with commercial and government payers, including credentialing and re-credentialing.<o:p></o:p></span></li> <li class="MsoNormal" style="margin-bottom:0in;mso-list:l0 level1 lfo1; tab-stops:list .5in"><span style="font-size:11.0pt;line-height:115%; font-family:"Calibri",sans-serif">Monitor provider enrollment status and proactively address credentialing denials or delays in collaboration with AR and internal teams.<o:p></o:p></span></li> <li class="MsoNormal" style="margin-bottom:0in;mso-list:l0 level1 lfo1; tab-stops:list .5in"><span style="font-size:11.0pt;line-height:115%; font-family:"Calibri",sans-serif">Submit new network participation requests to payers to expand provider access and participation opportunities.<o:p></o:p></span></li> <li class="MsoNormal" style="margin-bottom:0in;mso-list:l0 level1 lfo1; tab-stops:list .5in"><span style="font-size:11.0pt;line-height:115%; font-family:"Calibri",sans-serif">Ensure timely submission of required documentation to prevent payer terminations and reimbursement disruptions.<o:p></o:p></span></li> <li class="MsoNormal" style="margin-bottom:0in;mso-list:l0 level1 lfo1; tab-stops:list .5in"><span style="font-size:11.0pt;line-height:115%; font-family:"Calibri",sans-serif">Serve as a liaison between providers and payers, resolving enrollment issues and clarifying requirements.<o:p></o:p></span></li> <li class="MsoNormal" style="margin-bottom:0in;mso-list:l0 level1 lfo1; tab-stops:list .5in"><span style="font-size:11.0pt;line-height:115%; font-family:"Calibri",sans-serif">Maintain accurate records of provider enrollment status, network participation, and payer communications.<o:p></o:p></span></li> <li class="MsoNormal" style="margin-bottom:0in;mso-list:l0 level1 lfo1; tab-stops:list .5in"><span style="font-size:11.0pt;line-height:115%; font-family:"Calibri",sans-serif">Identify trends in enrollment or credentialing issues and recommend process improvements.<o:p></o:p></span></li> <li class="MsoNormal" style="margin-bottom:0in;mso-list:l0 level1 lfo1; tab-stops:list .5in"><span style="font-size:11.0pt;line-height:115%; font-family:"Calibri",sans-serif">Stay current on payer requirements, regulatory updates, and credentialing best practices.<o:p></o:p></span></li></ul><p class="MsoNormal" style="margin-bottom:0in"><span style="font-size:11.0pt;line-height:115%;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p><p class="MsoNormal" style="margin-bottom:0in"><b><span style="font-size:11.0pt;line-height:115%;font-family:"Calibri",sans-serif">Qualifications<o:p></o:p></span></b></p><ul style="margin-top:0in" type="disc"> <li class="MsoNormal" style="margin-bottom:0in;mso-list:l2 level1 lfo2; tab-stops:list .5in"><span style="font-size:11.0pt;line-height:115%; font-family:"Calibri",sans-serif">2+ years of experience in provider enrollment, credentialing, or payer relations.<o:p></o:p></span></li> <li class="MsoNormal" style="margin-bottom:0in;mso-list:l2 level1 lfo2; tab-stops:list .5in"><span style="font-size:11.0pt;line-height:115%; font-family:"Calibri",sans-serif">Knowledge of commercial and government payer enrollment processes, credentialing, and re-credentialing.<o:p></o:p></span></li> <li class="MsoNormal" style="margin-bottom:0in;mso-list:l2 level1 lfo2; tab-stops:list .5in"><span style="font-size:11.0pt;line-height:115%; font-family:"Calibri",sans-serif">Strong organizational skills with the ability to manage multiple priorities and deadlines.<o:p></o:p></span></li> <li class="MsoNormal" style="margin-bottom:0in;mso-list:l2 level1 lfo2; tab-stops:list .5in"><span style="font-size:11.0pt;line-height:115%; font-family:"Calibri",sans-serif">Excellent communication and collaboration skills for working with providers, payers, and internal teams.<o:p></o:p></span></li> <li class="MsoNormal" style="margin-bottom:0in;mso-list:l2 level1 lfo2; tab-stops:list .5in"><span style="font-size:11.0pt;line-height:115%; font-family:"Calibri",sans-serif">Detail-oriented with a strong focus on compliance and revenue protection.<o:p></o:p></span></li> <li class="MsoNormal" style="margin-bottom:0in;mso-list:l2 level1 lfo2; tab-stops:list .5in"><span style="font-size:11.0pt;line-height:115%; font-family:"Calibri",sans-serif">Proficiency with credentialing platforms such as CAQH or CredentialStream and the Microsoft Office Suite.</span></li><li class="MsoNormal" style="margin-bottom:0in;mso-list:l1 level1 lfo3; tab-stops:list .5in"><span style="font-size:11.0pt;line-height:115%; font-family:"Calibri",sans-serif">Experience in healthcare revenue cycle, provider network management, or payer contracting preferred.<o:p></o:p></span></li> <li class="MsoNormal" style="margin-bottom:0in;mso-list:l1 level1 lfo3; tab-stops:list .5in"><span style="font-size:11.0pt;line-height:115%; font-family:"Calibri",sans-serif">Familiarity with Medicare, Medicaid, and commercial payer enrollment processes preferred.<o:p></o:p></span></li></ul><p class="MsoNormal" style="margin-bottom:0in"><span style="font-size:11.0pt;line-height:115%;font-family:"Calibri",sans-serif"><o:p> </o:p></span></p> |