Payer Enrollment Specialist

OpenLoop Health, Inc.; Iowa (LA); Remote; USD 60,000 - 70,000; Full time

Job summary

OpenLoop Health, Inc. seeks a Payer Enrollment Specialist to enhance provider enrollment processes across Medicare and Medicaid. The role involves managing applications, ensuring compliance, and liaising with payers to resolve issues, offering a competitive salary and a supportive company culture.

Benefits

Medical, Dental, and Vision plans

Flexible Spending/Health Savings Accounts

Flexible PTO

401(k) + Company Match

Life Insurance, Pet Insurance, and more

Qualifications

• 3–5+ years in provider enrollment or credentialing.
• Strong familiarity with Medicare, Medicaid, and commercial payer processes.
• Proficiency in CAQH and PECOS.

Responsibilities

• Lead provider enrollment with Medicare and Medicaid.
• Manage credentialing processes and compliance.
• Maintain provider records and resolve issues.

Skills

Attention to Detail

Organizational Skills

Communication Skills

Tools

CAQH

PECOS

Job description

The future of healthcare works at OpenLoop.

United States - Remote

About the Role

OpenLoop is looking fora Payer Enrollment Specialist to join our team remotely or atHQ in Des Moines, IA. In this role, you will be responsible for managing andstreamlining provider enrollments with government and commercial insurancepayers. This role is essential for ensuring compliance, optimizing credentialingprocesses, and maintaining provider relationships with Medicare, Medicaid, andprivate insurance networks.

WhatYou'll Do

• Lead provider enrollment withMedicare, Medicaid, and commercial payers across all 50states.
• Manage credentialing processes, including applicationsubmission, follow-ups, and ongoing compliance.
• Utilize CAQH and PECOS to verify provider credentialsand maintain accurate enrollment data.
• Maintain up-to-date providerrecords, ensuring timely renewals and contract modifications.
• Communicate with payers, providers, and internal teams to resolveenrollment and credentialing issues.
• Ensure all provider dataaligns with state and federal regulations, as well as individual payerrequirements.
• Identify process improvements to enhance efficiency andreduce delays in provider onboarding.
• Stay informed about enrollmentregulations and changes in payer policies affecting providerparticipation.
• Other duties as assigned

Who You Are

• 3– 5+years in provider enrollment, credentialing, or payer relations.
• Strongfamiliarity with Medicare and Medicaid enrollment processes, along withcommercial payer requirements.
• Proficiency in CAQH and PECOSfor provider credentialing and enrollment.
• Exceptional attention todetail, organizational skills, and ability to manage multiple enrollmentssimultaneously.
• Strong verbal and written communication skills toliaise with providers and payers effectively.
• Comfortable working with enrollment software and maintaining digitalrecords.

Remote Salary Range

$60,000 — $70,000 USD

About OpenLoop

Our Company Culture

We have a relatively flat organizational structurehere at OpenLoop. Everyone is encouraged to bring ideas to the table and makethings happen. This fits in well with our core values of Autonomy, Competenceand Belonging, as we want everyone to feel empowered and supported to do theirbest work.

In addition,for salaried positions you would also be eligible for:

• Medical, Dental, and Vision plans
• FlexibleSpending/Health Savings Accounts
• Flexible PTO
• 401(k) + Company Match
• Life Insurance, Pet insurance,and more

Sound like a good fit? We’d love to meetyou.