Payor Enrollment Specialist (Medicare or Medicaid exp preferred) (Provider Enrollment Dept) - REMOTE

Vanderbilt University Medical Center; Vaughan; Remote; CAD 50,000 - 70,000; Full time

Job summary

A leading healthcare organization is seeking a Payor Enrollment Specialist to manage the enrollment of healthcare providers with insurance payors. The role involves coordinating applications, maintaining records, and ensuring compliance. Candidates should have 4 years of relevant experience and a High School Diploma. This position offers an opportunity to work in a supportive environment dedicated to professional growth.

Qualifications

• 4 years of experience in relevant work.
• High School Diploma or GED required.

Responsibilities

• Manage the process of enrolling healthcare providers with insurance payors.
• Coordinate provider enrollment and maintain records.
• Verify and update data with insurance payors.

Skills

Regulatory awareness

Problem solving

Customer service

Communication

Insurance regulatory knowledge

Education

High School Diploma or GED

Job description

Payor Enrollment Specialist (Medicare or Medicaid exp preferred) (Provider Enrollment Dept) - REMOTE

Discover Vanderbilt University Medical Center: Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals dedicated to changing the world. Your expertise will be valued, and your abilities challenged. Vanderbilt Health promotes an environment where everyone can thrive, and your uniqueness is celebrated. Our mission is to advance health and wellness through outstanding programs in patient care, education, and research.

Organization: Payor/Provider Enrollment

Job Summary: A payor enrollment specialist manages the process of enrolling healthcare providers with insurance payors or health plans, including completing applications, verifying credentials, ensuring compliance, maintaining records, updating provider information, and resolving enrollment issues. They communicate with providers and payors to facilitate smooth enrollment and billing.

Key Responsibilities:

• Coordinate and assist in provider enrollment, maintenance, revalidation, and submission of data/documents for claims submission.
• Ensure enrollment with outside affiliates through data and document collection and reporting.
• Maintain provider records, payor applications, and follow-up with payors.
• Verify and update data with insurance payors, and prepare information for audits.

Technical Capabilities:

• Regulatory awareness, problem solving, revenue cycle software proficiency, discretion & privacy, customer service, communication, insurance regulatory knowledge.

Our functions support IT, finance, administration, legal, HR, marketing, and more. We foster a supportive environment where high-achieving employees grow professionally and feel appreciated.

Core Accountabilities:

• Routine tasks impacting team performance, problem solving, applying standards, guiding entry-level coworkers.

Core Capabilities:

• Supporting colleagues, developing self and others, building relationships, effective communication, delivering service, ensuring quality, managing resources, fostering innovation, adapting to change.

Position Qualifications:

• Experience: 4 years in relevant work
• Education: High School Diploma or GED

Vanderbilt is committed to equal opportunity and fostering a thriving environment.