Enrollments Specialist

Ap-Health; Nashville (TN); On-site; USD 60,000 - 75,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

401K retirement plan with company匹配

ESOP

CME stipend

Paid time off (PTO)

Job summary

AP Health in Nashville, TN seeks an experienced Payer Enrollment Specialist to manage end-to-end enrollment with in-network payers and maintain an active provider roster.

You will collaborate with the Revenue Cycle Management team to troubleshoot denials, coordinate onboarding, and maintain CAQH profiles, while ensuring HIPAA compliance. This role offers competitive benefits and a path toward ownership opportunities in a private practice.

Qualifications

• 2+ years in healthcare revenue cycle with 2+ years managing payer enrollments (Medicare, Medicaid, and Commercial).
• Knowledge of payer enrollment processes and reimbursement rules.
• Familiarity with payer portals Availity and Optum.
• HIPAA and healthcare data standards compliance.
• Strong written and verbal communication and collaboration.

Responsibilities

• Oversee end-to-end provider enrollment with in-network payers and maintain active roster.
• Collaborate with Revenue Cycle Management to resolve denials.
• Coordinate onboarding with providers and payers to complete enrollment timely.
• Navigate payer portals to submit applications, track statuses, resolve delays.
• Support CAQH/credentialing updates across employee lifecycle.

Skills

Payer enrollments

Revenue cycle

HIPAA compliance

Communication

Onboarding coordination

Education

Associate’s or Bachelor’s in healthcare administration

PECOS/CAQH certification

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.

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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.