Payer Enrollment Specialist

Freddie Mac; United States; Remote; USD 55,000 - 75,000; Full time

Job summary

A leading company in virtual mental healthcare seeks an experienced Payer Enrollment Specialist to join their credentialing team. The ideal candidate will have enrollment experience, strong communication skills, and a detail-oriented approach to work efficiently while collaborating with various stakeholders and ensuring accurate enrollment processes.

Benefits

Fully paid comprehensive health care (medical, dental, vision)

Pet Insurance

Life Insurance & Short/Long Term Disability

401k Plan

Unlimited PTO and sick leave

Parental Leave

Flexible remote work hours

Additional memberships and perks

Qualifications

• 2+ years of enrollment experience with health plans, especially Medicare and Medicaid.
• Experience with credentialing processes is a plus.
• Knowledge of NCQA requirements preferred.

Responsibilities

• Enroll clinicians in contracted health plans.
• Maintain CAQH and PECOS profiles.
• Document activities and keep accurate records.

Skills

Detail-oriented

Time management

Communication

Proactive

Tools

Salesforce

CAQH

PECOS

Availity

Job description

Brightside Health delivers life-saving virtual mental healthcare to everyone who needs it. We are powered by proprietary AI, purpose-built technology, a world-class clinician network, and a care model that rivals the best of in-person treatment. When combined with precision psychiatry and leading-edge therapeutic techniques, we're able to improve outcomes for those with mild-to-severe clinical depression, anxiety, and other mood disorders.

We take an action-oriented, purposeful approach with everything we do and seek out team members who value collaboration and thoughtful prioritization. As a result, our organization is looking for the brightest and most innovative talent in the industry. We can promise you that, as a member of the Brightside team, you'll have the opportunity to collaborate alongside smart and driven people while growing your professional skills.

We are looking for an experienced Payer Enrollment Specialist to join our expanding credentialing team, reporting directly to the Senior Manager, Credentialing and Enrollment. In this role, you will be responsible for enrolling all clinicians in contracted health plans. You will partner closely with our commercial team and external payers. Ultimately, this role will be responsible for accurately and timely enroll clinicians in health plans across the US. Continuous and persistent follow-up with payers for statuses is important all while building effective relationships with contacts.

What you'll be doing as a Payer Enrollment Specialist:

• Initiate online and paper group and individual enrollment application submissions for new and existing contracted commercial payers.
• Follow up on submitted enrollment applications to completion, escalating to leadership as needed
• Respond to internal requests for information, including status updates
• Maintain a list of contacts with various payers
• Work with providers to obtain information needed to complete enrollment applications and follow up as necessary
• Maintain CAQH and PECOS profiles
• Work collaboratively across departments
• Ensure provider demographic data is kept up to date in credentialing system and with applicable payers
• Document all activity and maintain accurate records in the credentialing system
• Maintain confidentiality
• Perform other duties as assigned

Requirements:

• 2+ years of experience enrolling with health plans (Medicare and Medicaid programs would be a nice to have)
• Proficiency with applicable online portals, including but not limited to CAQH, PECOS, and Availity
• Ability to work quickly and efficiently while maintaining accuracy
• Excellent verbal, written, and social skills
• Self-starter with the ability to work independently and proactively
• Highly detail-oriented
• Able to work under pressure and adapt easily to change
• Consistently create a positive work environment by being team-oriented
• Excellent time and workload management skills
• Experience with credentialing processes is a plus
• Experience with Salesforce is an additional plus
• Knowledge of NCQA requirements, preferred

Benefits:

• Fully paid for comprehensive health care (medical, dental, vision)
• Pet Insurance
• Life Insurance & Short / Long Term Disability
• 401k Plan
• Unlimited PTO and sick leave
• Parental Leave
• Work remotely with flexible hours for optimal productivity
• Additional memberships and perks

Final offer amounts are determined by multiple factors, including geographic location as well as candidate experience and expertise. If you have questions on compensation bands, please ask your recruiter.

Brightside Health is committed to equal employment opportunities for all team members. Every decision we make regarding employment is solely based on merit, competence, and performance. We are committed to building a team that represents a variety of backgrounds, perspectives, and skills. We realize the full promise of diversity and want you to bring your whole self to work every single day.

Research shows that underrepresented groups typically apply only if they meet 100% of the criteria listed. At Brightside, we are dedicated to fair play and encourage women, people of color, and LGBTQ+ job seekers to apply for positions even if they don't check every box for the role.