Healthcare Enrollment & Payer Relations Specialist

VOLTO Consulting; Philadelphia (Philadelphia County); On-site; USD 42,000 - 62,000; Full time

Job summary

VOLTO Consulting is seeking a detail-oriented professional for insurance verification, billing and provider relations in a healthcare setting. The role requires at least two years of relevant experience and strong organizational skills.

You will coordinate with payers, maintain provider information, support enrollment and re-credentialing, and ensure timely reimbursement. Knowledge of Medicare/Medicaid, ECHO, NAVINET and CAQH and MS Office is essential; collaboration with stakeholders at all

Qualifications

• Minimum two years of experience in insurance verification or billing.
• Experience in provider relations within a healthcare organization.
• Knowledge of Medicare and Medicaid policies.

Responsibilities

• Reviews and prepares new hire enrollment packets for accuracy and timely submission to payers and maintains provider information for timely reimbursement.
• Performs follow-up with physicians to obtain documentation for enrollment/re-credentialing (renewals due 30 days before expiration).
• Maintains knowledge of payer processes and keeps physician database and NPPES current.
• Maintains files, scans credentials, and notifies administrators of deadlines.
• Initiates calls and correspondence to payers to ensure timely receipt of enrollment dates and numbers.
• Documents all payer contacts and correspondence for future reference.
• Reviews and provides research to Billing to assist with claims issue resolution.

Skills

Insurance verification

Billing

Provider relations

Payer processes

Analytical thinking

Tools

ECHO

NAVINET

CAQH

Job description

VOLTO Consulting is seeking a detail-oriented professional for insurance verification, billing and provider relations in a healthcare setting. The role requires at least two years of relevant experience and strong organizational skills.

You will coordinate with payers, maintain provider information, support enrollment and re-credentialing, and ensure timely reimbursement. Knowledge of Medicare/Medicaid, ECHO, NAVINET and CAQH and MS Office is essential; collaboration with stakeholders at all