Healthcare Payer Enrollment Specialist

TeleSpecialists; Brookhaven (GA); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

Tuition reimbursement

Paid vacation

Leadership training

Job summary

TeleSpecialists in Brookhaven, GA seeks a Payer Enrollment Team Member to enroll TeleSpecialists providers with Medicare, state Medicaid and commercial carriers, and to maintain CAQH, PECOS and NPPES profiles.

You will complete enrollment applications, update provider demographics, manage CAQH and Availity portals, and ensure timely submissions. Payer enrollment experience and credentialing software experience are required; Joint Commission/NCQA experience is a plus.

Qualifications

• Payer Enrollment experience required.
• Credentialing software experience required; MD Staff preferred.
• Experience with Joint Commission or National Committee for Quality Assurance preferred.

Responsibilities

• Complete initial, reassignment and re-validation Medicare apps for facilities and providers.
• Complete initial, reassignment and re-validation apps with various state Medicaid’s for facilities and providers.
• Ensure physician Medicare re-validation apps for Commercial insurance networks are completed on time.
• Maintain PECOS portal for providers, including approval of facilities and updating demographic information.
• Manage and Maintain NPPES portal for providers.
• Create, update, and maintain CAQH profiles for providers.
• Manage Practice Manager CAQH profile for all providers and facilities.
• Manage password updates for various enrollment portals, included but not limited to CAQH, Medicare and Medicaid.
• Updating and maintaining MD Staff with the progress of all activities.
• Complete facility payer enrollment paperwork for providers and return to the facility in a timely manner.
• Manage Availity portal for various insurance networks.

Skills

Payer Enrollment

Credentialing software

Communication

Tools

MD Staff

CAQH

PECOS

NPPES

Availity

Job description

TeleSpecialists in Brookhaven, GA seeks a Payer Enrollment Team Member to enroll TeleSpecialists providers with Medicare, state Medicaid and commercial carriers, and to maintain CAQH, PECOS and NPPES profiles.

You will complete enrollment applications, update provider demographics, manage CAQH and Availity portals, and ensure timely submissions. Payer enrollment experience and credentialing software experience are required; Joint Commission/NCQA experience is a plus.