Payer Connectivity Program Coordinator

WellSky Financial Services; United States; On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical Insurance

Dental & Vision

Mental Health support

PTO + Holidays

401(k) Plan

Educational assistance

Job summary

The Program Coordinator - Payer Connectivity at WellSky oversees payer setup, enrollment, and connectivity across multiple EHR and revenue cycle platforms, serving as the subject matter expert for payer architecture and electronic transactions.

The role coordinates end-to-end payer ecosystems supporting electronic claims submission, ERA, EFT, and related processes, ensuring compliance with HIPAA and payer requirements while driving process improvements at the World Head Quarters in Overland

Qualifications

• Bachelor’s Degree or equivalent work experience
• 3–5 years of relevant work experience
• Direct experience with payer enrollment, EDI transactions, clearinghouse operations, and payer connectivity
• Familiarity with process mapping and documentation tools
• Strong working knowledge of Medicare, Medicaid and Commercial Payers
• Working knowledge of healthcare EDI transactions, including: 837 Claims 835 Remittance 277CA Acknowledgments 999 Transactions 270/271 Eligibility

Responsibilities

• Own payer setup, configuration, enrollment, and maintenance across EHR, clearinghouse, and revenue cycle systems.
• Manage electronic claims, ERA, EFT, and trading partner enrollments.
• Support payer onboarding, EDI testing, connectivity validation, and issue resolution.
• Serve as the primary liaison for payer and clearinghouse relationships.
• Partner with cross-functional teams to optimize payer workflows and claims processing.
• Investigate enrollment, connectivity, and claims issues; perform root cause analysis and coordinate resolutions.
• Maintain payer configurations, reporting, and system documentation.
• Ensure compliance with HIPAA, CMS, state, and payer requirements with respect to electronic claims transmission and management processes.

Skills

Payer enrollment

EDI transactions

Payer connectivity

HIPAA compliance

Documentation tools

Education

Bachelor's Degree

Tools

Clearinghouse software

EHR integrations

Job description

The Program Coordinator - Payer Connectivity at WellSky oversees payer setup, enrollment, and connectivity across multiple EHR and revenue cycle platforms, serving as the subject matter expert for payer architecture and electronic transactions.

The role coordinates end-to-end payer ecosystems supporting electronic claims submission, ERA, EFT, and related processes, ensuring compliance with HIPAA and payer requirements while driving process improvements at the World Head Quarters in Overland