Payer Enrollment Specialist

OpenLoop; United States; Remote; USD 60,000 - 70,000; Full time

Job summary

OpenLoop is seeking a Payer Enrollment Specialist to enhance its team, focusing on managing provider enrollments efficiently with insurance payers. Responsibilities include leading enrollments, managing credentialing processes, and ensuring compliance with regulations. This remote role offers a competitive salary range and the opportunity to work in a dynamic environment.

Benefits

Medical, Dental, and Vision plans

Flexible Spending/Health Savings Accounts

Flexible PTO

401(k) + Company Match

Life Insurance

Pet insurance

Qualifications

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

Responsibilities

• Lead provider enrollment with Medicare, Medicaid, and commercial payers across all 50 states.
• Manage credentialing processes, including application submission and compliance.
• Communicate with payers, providers, and teams to resolve enrollment issues.

Skills

Attention to Detail

Organizational Skills

Communication

Familiarity with Medicare and Medicaid

Credentialing

Education

3–5+ years in provider enrollment or credentialing

Tools

CAQH

PECOS

Job description

Join to apply for the Payer Enrollment Specialist role at OpenLoop

Join to apply for the Payer Enrollment Specialist role at OpenLoop

OpenLoop is looking for a Payer Enrollment Specialist to join our team remotely or at HQ in Des Moines, IA. In this role, you will be responsible for managing and streamlining provider enrollments with government and commercial insurance payers. This role is essential for ensuring compliance, optimizing credentialing processes, and maintaining provider relationships with Medicare, Medicaid, and private insurance networks.

What You'll Do

• Lead provider enrollment with Medicare, Medicaid, and commercial payers across all 50 states.
• Manage credentialing processes, including application submission, follow-ups, and ongoing compliance.
• Utilize CAQH and PECOS to verify provider credentials and maintain accurate enrollment data.
• Maintain up-to-date provider records, ensuring timely renewals and contract modifications.
• Communicate with payers, providers, and internal teams to resolve enrollment and credentialing issues.
• Ensure all provider data aligns with state and federal regulations, as well as individual payer requirements.
• Identify process improvements to enhance efficiency and reduce delays in provider onboarding.
• Stay informed about enrollment regulations and changes in payer policies affecting provider participation.
• Other duties as assigned

Who You Are

• 3– 5+ years in provider enrollment, credentialing, or payer relations.
• Strong familiarity with Medicare and Medicaid enrollment processes, along with commercial payer requirements.
• Proficiency in CAQH and PECOS for provider credentialing and enrollment.
• Exceptional attention to detail, organizational skills, and ability to manage multiple enrollments simultaneously.
• Strong verbal and written communication skills to liaise with providers and payers effectively.
• Comfortable working with enrollment software and maintaining digital records.

Remote Salary Range: $60,000 USD - $70,000 USD

About the Role

OpenLoop is looking for a Payer Enrollment Specialist to join our team remotely or at HQ in Des Moines, IA. In this role, you will be responsible for managing and streamlining provider enrollments with government and commercial insurance payers. This role is essential for ensuring compliance, optimizing credentialing processes, and maintaining provider relationships with Medicare, Medicaid, and private insurance networks.

What You'll Do

• Lead provider enrollment with Medicare, Medicaid, and commercial payers across all 50 states.


• Manage credentialing processes, including application submission, follow-ups, and ongoing compliance.


• Utilize CAQH and PECOS to verify provider credentials and maintain accurate enrollment data.


• Maintain up-to-date provider records, ensuring timely renewals and contract modifications.


• Communicate with payers, providers, and internal teams to resolve enrollment and credentialing issues.


• Ensure all provider data aligns with state and federal regulations, as well as individual payer requirements.


• Identify process improvements to enhance efficiency and reduce delays in provider onboarding.


• Stay informed about enrollment regulations and changes in payer policies affecting provider participation.


• Other duties as assigned

Who You Are

• 3– 5+ years in provider enrollment, credentialing, or payer relations.


• Strong familiarity with Medicare and Medicaid enrollment processes, along with commercial payer requirements.


• Proficiency in CAQH and PECOS for provider credentialing and enrollment.


• Exceptional attention to detail, organizational skills, and ability to manage multiple enrollments simultaneously.


• Strong verbal and written communication skills to liaise with providers and payers effectively.


• Comfortable working with enrollment software and maintaining digital records.

Remote Salary Range: $60,000 USD - $70,000 USD

About OpenLoop

OpenLoop was co-founded by CEO, Dr. Jon Lensing, and COO, Christian Williams, with the vision to bring healing anywhere. Our tele-health support solutions are thoughtfully designed to streamline and simplify go-to-market care delivery for companies offering meaningful virtual support to patients across an expansive array of specialties, in all 50 states.

Our Company Culture

We have a relatively flat organizational structure here at OpenLoop. Everyone is encouraged to bring ideas to the table and make things happen. This fits in well with our core values of Autonomy, Competence and Belonging, as we want everyone to feel empowered and supported to do their best work.

Our Benefits

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

• Medical, Dental, and Vision plans


• Flexible Spending/Health Savings Accounts


• Flexible PTO


• 401(k) + Company Match


• Life Insurance, Pet insurance, and more

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

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  Hospitals and Health Care

Referrals increase your chances of interviewing at OpenLoop by 2x

Sign in to set job alerts for “Enrollment Specialist” roles.

New York, United States $20.00-$30.00 5 months ago

Full Time Executive Assistant - Remote (PH)

Enrollment Specialist (Remote - Call Center)

United States $78,000.00-$170,000.00 1 month ago

Data Entry Clerk - Typist / Full-time (Remote)

United States $25,200.00-$31,500.00 16 hours ago

United States $65,000.00-$95,000.00 1 day ago

Customer Experience Associate I - Remote

Massachusetts, United States $20.00-$23.00 1 day ago

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.