Payer Enrollment & Relations Specialist

QHR Health, LLC dba Ovation Healthcare; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

Ovation Healthcare seeks a Specialist, Payer Relations to guide clients through the provider enrollment lifecycle, advise on billing structure, and ensure regulatory compliance. The role entails enrolling providers with Medicare, Medicaid, and private payers, maintaining CAQH profiles and NPI records, monitoring deadlines, and coordinating with clients, payers, and internal teams to resolve issues.

The ideal candidate has 3+ years in enrollment or credentialing, strong communication, and

Qualifications

• Associate or Bachelor’s degree in healthcare administration, business, or a related field preferred.
• Minimum of 3 years of experience in provider enrollment, payer enrollment, billing, credentialing, or a client-facing healthcare services role.

Responsibilities

• Manage end-to-end provider enrollment including initial enrollment, recredentialing, revalidation, and payer contracting readiness.
• Serve as SME on enrollment requirements, billing processes, payer setup, best practices, and compliance standards.
• Prepare, complete, and submit enrollment applications for providers and facilities across commercial and government payers.

Skills

Attention to detail

Strong communication

Microsoft Office

Credentialing systems

Education

Associate or Bachelor’s degree in healthcare administration, business, or related field

Tools

CAQH

PECOS

Availity

Job description

Ovation Healthcare seeks a Specialist, Payer Relations to guide clients through the provider enrollment lifecycle, advise on billing structure, and ensure regulatory compliance. The role entails enrolling providers with Medicare, Medicaid, and private payers, maintaining CAQH profiles and NPI records, monitoring deadlines, and coordinating with clients, payers, and internal teams to resolve issues.

The ideal candidate has 3+ years in enrollment or credentialing, strong communication, and