Payer Enrollment & Credentialing Specialist

Union-Community-Care; Lancaster (Lancaster County); On-site; USD 55,000 - 75,000; Full time

Job summary

Union Community Care in Lancaster, PA is seeking a Billing Team Lead with expertise in enrollment and credentialing to strengthen our payer interactions and revenue cycle workflows.

You will oversee enrollment activities, maintain CAQH and provider records, and collaborate with payers, providers, and internal teams to ensure accurate billing and timely credentialing. A focus on HIPAA compliance and process improvement is essential.

Qualifications

• 3 years minimum experience in a payer enrollment related field.
• Knowledge of managed care operations including enrollment, credentialing, contracting and claims.
• Excellent written and oral communication skills.
• Strong organizational, problem solving and decision-making skills.
• Spanish proficiency preferred.
• Knowledge of CPT/CDT guidelines preferred and HIPAA familiarity.

Responsibilities

• Completing all initial payer enrollment applications for commercial and government payers and completing timely follow up.
• Completing and maintaining CAQH profiles for all providers and ensuring re-credentialing is timely.
• Maintaining credentialing and billing information in enrollment systems and communicating with payers and providers.
• Maintaining knowledge of current health plan requirements for credentialing and enrollment.
• Ensuring practice addresses are current with plans, agencies, and entities and maintaining confidentiality of provider information.
• Responding to enrollment dashboard tasks and coordinating with Athena Health Enrollment Services as needed.
• Processes and posts insurance and patient payments in accordance with policies.

Skills

Payer enrollment

Credentialing

Billing/Enrollment operations

HIPAA compliance

Communication skills

Tools

Microsoft Office

EMR software

Billing systems

Job description

Union Community Care in Lancaster, PA is seeking a Billing Team Lead with expertise in enrollment and credentialing to strengthen our payer interactions and revenue cycle workflows.

You will oversee enrollment activities, maintain CAQH and provider records, and collaborate with payers, providers, and internal teams to ensure accurate billing and timely credentialing. A focus on HIPAA compliance and process improvement is essential.