Enrollment Specialist

PayrHealth; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A leading company in managed care contracting is seeking an Enrollment Specialist to assist with payer enrollment processes. This full-time remote position involves ensuring accurate application submissions, maintaining data integrity, and providing excellent client support. Ideal candidates will possess strong analytical and communication skills, along with knowledge of various payor systems. Join a dynamic team dedicated to supporting healthcare providers and enjoy competitive compensation and benefits.

Benefits

Health Insurance

Vision Insurance

401K program

Unlimited Paid Time Off

Qualifications

• Prefer at least one year of direct experience with payor enrollment.
• Knowledge of multiple state commercial, Medicaid, and MCO plans.

Responsibilities

• Ensure payer applications are completed accurately and submitted timely.
• Maintain current knowledge regarding the enrollment process for payors.
• Obtain missing documents and ensure enrollment is not delayed.

Skills

Critical Thinking

Analytical Skills

Research Skills

Interpersonal Skills

Verbal Communication

Written Communication

Education

High School Diploma or GED

Tools

Credentialing Software

CAQH

Availity

PECOS

NPPES

I&A

Job description

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Payrhealth has been the leader in managed care contracting outsourcing for over 25 years. At the core of our business, we help healthcare providers increase their revenue by obtaining new and more profitable contracts with payers. While contracting, renegotiation, and credentialing support are the core of our business today, we are continually looking for more ways to expand our services to support healthcare providers. Payrhealth was recently acquired by Osceola Capital Management, a private equity firm planning to further invest in the capabilities and resources we offer.

The Enrollment Specialist is responsible for several key components within the process of payer enrollment for our clients comprising of individuals, groups, clinics & ancillary facilities. The Enrollment Specialist is responsible for assisting in various stages of the process including but not limited to collecting information needed for enrollment, follow up with payers, follow up with clients, completing and submitting payer applications, and ensuring status of applications is current for client reports. Maintains data quality and integrity. Carries out all duties while maintaining compliance and confidentiality, promoting the mission and philosophy of the organization, and fostering a professional, positive work environment.

Role Responsibilities:

• Ensure that payer applications are completed accurately and submitted timely.
• Expected to maintain current knowledge regarding the enrollment process for payors.
• Ensure that status information reported to clients is accurate and easy to understand.
• Obtain any missing/expired documents, signatures and/or information from clients/providers as requested by health plans.
• Obtain appropriate access to payer portals as required to complete various enrollments.
• Aid clients as needed for obtaining portal access; ensure that enrollment is not delayed due to portal access issues.
• May be asked to assist with other administrative tasks of the department, as needed.
• Performs other duties as assigned by supervisor and/or Members of Leadership Team.
• Requires critical thinking and analytical skills, decisive judgment, and the ability to work with minimal supervision.
• Strong research skills to gather pertinent information regarding health plans and application processes.
• Auditing paperwork such as applications and supporting documentation for accuracy.
• Must be able to work in a stressful environment and take appropriate action.
• Strong interpersonal skills along with demonstrated verbal and written communication skills needed.
• Knowledgeable of current trends and practices in all aspects of payor enrollment.

Basic Qualifications:

• High School Diploma or GED required
• Prefer at least one year of direct experience, preferably with direct knowledge of multiple state commercial, Medicaid and Medicaid MCO plans.
• Prefer experience with CAQH, Availity, PECOS, NPPES, I&A, and other commercial payor portals preferred.
• Prefer experience with Credentialing software preferred: CredentialStream, Veritystream, Echostream, Modio or Symplr.

This is a full-time remote position. Compensation is a competitive salary and bonus structure complemented by a full benefits package.

Benefits include:

• Health Insurance
• Vision Insurance
• 401K program
• Unlimited Paid Time Off

Company Culture & Values

We are a small and growing team, so your responsibilities will evolve rapidly. You will be challenged and supported by a great team in an environment where you can move fast, work hard, and see results.

EEO Statement: PayrHealth provides equal employment opportunities (EEO) to all employees and applicants without regard to race, color, religion, sex, national origin, age, disability, or genetics. We comply with all applicable federal, state, and local laws governing nondiscrimination in employment. This policy applies to all terms and conditions of employment.

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider and Other

• Industries

  Hospitals and Health Care

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Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

Paid maternity leave

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