Enrollments Specialist

AP Health; Nashville (TN); On-site; USD 60,000 - 85,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

401K with company matching

ESOP

CME allowance

Paid time off (PTO)

Great Place to Work designation

Job summary

AP Health in Nashville, TN seeks to hire for a payer enrollment operations role to oversee end-to-end provider enrollment with in-network payers and maintain an active roster.

You will collaborate with the Revenue Cycle Management team to resolve denials, coordinate enrollments during onboarding, and navigate Availity/Optum portals to track statuses efficiently.

Qualifications

• 2+ years in healthcare revenue cycle with payer enrollments
• Knowledge of enrollment rules and payer workflows
• Experience with Availity or Optum portals
• HIPAA and healthcare standards compliance
• Strong communication and problem-solving skills

Responsibilities

• Oversee end-to-end provider enrollment with in-network payers and active roster
• Collaborate with Revenue Cycle Management to resolve denials
• Coordinate enrollment upon provider hire and throughout employment
• Navigate payer portals (Availity, Optum) to submit and track applications
• Partner with People Operations during onboarding for timely enrollments
• Manage CAQH profiles across employee lifecycle
• Assist in establishing Revenue Cycle SOPs and data workflows

Skills

Payer enrollment

Revenue cycle experience

HIPAA compliance

Communication & collaboration

Portal familiarity

Education

Associate’s or Bachelor’s in healthcare administration, business, or related field

Equivalent experience accepted

Tools

Availity

Optum

Job description

AP Health offers skilled advanced practice providers an opportunity for career control, flexibility, competitive compensation and ownership interest in the company.

Are you ready for new challenges and new opportunities?

Join our team!

Current job opportunities are posted here as they become available.

Subscribe to our RSS feeds to receive instant updates as new positions become available.

AP Health is a private practice comprised of advanced practice providers. We provide perioperative services to hospitals, surgeons, and surgery centers. This role will specialize in payer enrollment operations for our facility-based model.

What you will do:

• Oversee and execute end-to-end provider enrollment processes with in-network payers while maintaining an active roster
• Work with the broader Revenue Cycle Management team to troubleshoot and work through denials as needed
• Connect with providers and payers to efficiently complete the enrollment process upon provider hire and maintain throughout their employment
• Navigate payer portals like Availity, Optum, and others to submit enrollment applications, track statuses, and resolve enrollment delays
• Collaborate with our People Operations team during the provider onboarding process to gather information and begin timely enrollments
• Manage providers CAQH profiles through employee lifecycle
• Assist in establishing Revenue Cycle SOPs and data workflows, providing feedback on enhancements for internal software and external leveraged resources

What do you need:

• 2+ years of experience in healthcare revenue cycle with 2+ years managing payer enrollments (Medicare, Medicaid, and Commerical)
• Knowledge of payer enrollment processes and reimbursement rules
• Familiarity with portals like Availity and Optum
• Comply with HIPAA regulations and other healthcare standards
• Excellent communication and collaboration skills with a problem-solving approach
• Preferred Associate’s or Bachelor’s in healthcare administration, business, or related field (*equivalent experience also accepted)
• Preferred certifications in PECOS/CAQH training
• Comprehensive and flexible medical, dental, and vision insurance
• Short and long-term disability, basic and supplemental life
• 401K retirement plan with company matching
• Participation in the company’s Employee Stock Option Plan (ESOP)
• Paid state license, malpractice, and other agreed upon licenses and dues
• Annual $1,500 allotment accompanied by 3 paid days off for Continuing Medical Education (CME)
• Generous PTO and "life/work" balance
• Excellence at Work: AP Health is a certified Great Place to Work™- a national designation based on employee feedback about trust, workplace culture, and experience.