Walk-in | Operation Associate - Payer Enrollment

Iopex; Chennai District; On-site; INR 300,000 - 600,000; Full time

Job summary

Iopex is seeking a Payer Enrollment professional to manage enrollment and credentialing with commercial, Medicare, and Medicaid payers. The role requires strong organization and a solid understanding of US regulations and revenue cycle processes.

The ideal candidate will handle submission of applications, maintain provider records, communicate with payer contacts, and ensure compliance across systems, including CAQH and PECOS, while collaborating with billing and provider relations teams.

Qualifications

• Experience in payer enrollment, credentialing, or medical billing within the US healthcare system.
• Bachelor's degree in healthcare administration or related field is preferred.
• Proficiency with Word and Excel and familiarity with credentialing software or payer portals (CAQH, PECOS).

Responsibilities

• Prepare and submit provider enrollment applications, re-enrollments, and re-credentialing documents to commercial, Medicare, and Medicaid payers.
• Maintain provider files with licenses, certifications, and credentialing paperwork with high attention to detail.
• Act as primary contact with payer representatives to track statuses and resolve denials or requests for more information.
• Enter and manage provider data in credentialing and billing software including CAQH and PECOS.
• Stay current with changes in payer enrollment regulations to ensure compliance with state and federal guidelines.
• Collaborate with billing, coding, and provider relations teams to ensure smooth onboarding to billing.

Skills

Attention to detail

Organizational skills

Communication skills

Independent worker

Problem-solving

Revenue cycle know-how

Education

Bachelor's degree

Tools

CAQH

PECOS

Microsoft Office

Job description

We're seeking a Payer Enrollment to manage the critical process of enrolling and credentialing healthcare providers with various insurance payers, including commercial, Medicare, and Medicaid plans. This role is essential for ensuring providers are able to bill for services and for maintaining a healthy revenue cycle. The ideal candidate will be highly organized and have a strong understanding of US healthcare regulations and credentialing processes.

Responsibilities

• Payer Enrollment and Credentialing: Prepare and submit provider enrollment applications, re-enrollments, and re-credentialing documents to commercial, Medicare, and Medicaid payers.
• Documentation Management: Maintain and update provider files with accurate information, including licenses, certifications, and other credentialing paperwork. This involves a high degree of attention to detail to prevent delays.
• Communication and Follow-up: Act as the primary point of contact with payer representatives to track application statuses, address issues, and resolve any denials or requests for additional information in a timely manner.
• Database Administration: Accurately enter and manage provider data within our credentialing and billing software, including systems like CAQH and PECOS.
• Compliance Monitoring: Stay current with changes in payer enrollment regulations and requirements to ensure all applications are compliant with state and federal guidelines.
• Internal Collaboration: Work closely with billing, coding, and provider relations teams to ensure a smooth and efficient process from provider onboarding to billing.

Qualifications

• Experience: At least 1 plus years of experience in payer enrollment, credentialing, or medical billing within the US healthcare system.
• Education: Bachelor's degree in healthcare administration or a related field is preferred.
• Technical Skills: Proficiency with Microsoft Office Suite (Word, Excel) and experience with credentialing software or payer portals (e.g., CAQH, PECOS).

Skills

• Exceptional attention to detail and organizational skills.
• Strong written and verbal communication skills.
• Ability to work independently, manage multiple deadlines, and problem-solve effectively.
• Knowledge of medical terminology and the US healthcare revenue cycle.