Payer Enrollment Team Lead

Our Billing Co; Buffalo (NY); On-site; USD 41,000 - 44,000; Full time

Benefits offered by this job

Competitive benefits package

Fully remote work

Job summary

Our Billing Co. in Buffalo, NY is seeking a Payer Enrollment Team Lead to guide credentialing specialists, train staff, and ensure compliant payer enrollment and re-credentialing processes.

The role emphasizes coaching, process improvement, and cross-department collaboration to maintain insurance participation for our providers and patients. This position is fully remote with a competitive benefits package.

Qualifications

• HS – High School Diploma or GED is required.
• AA – Associate of Arts is preferred.

Responsibilities

• Maintain Individual Payer Enrollment Workload
• Day to day guidance, training and support to credentialing specialists
• New Hire Training /Onboarding and Mentoring
• Helping staff members learn new skills and solve daily problems; hands on project support throughout team
• Works with other department managers and staff to acquire necessary materials for provider certification and licensure
• Helps Implement process and organization of all-payer credentialing and re-credentialing paperwork with participating insurance companies
• Assists with auditing provider credentialing and enrollment files for accuracy and compliance
• Key liaison with Medical Staff team, outside vendors
• Assists in completing and reviewing applications with practitioners and other staff
• Performs periodic quality assurance reviews and audits of credentialing, enrollment, and provider data files
• Assist with additional duties and departmental initiatives as assigned by leadership

Skills

Credentialing software

MS Office

Attention to detail

Time management

Communication

Team leadership

Education

High School Diploma or GED

Associate degree (AA)

Tools

Credentialing database software

Microsoft Excel

Microsoft Outlook

PowerPoint

Job description

The Payer Enrollment Team Lead is an important member of The Payer Enrollment Team. This individual will assist upper management daily by providing support and guidance to the team of Credentialing Specialists on daily tasks, processes, and workflow management. The Team Lead will serve as a resource for staff by providing ongoing training, mentoring, coaching, and knowledge sharing to support employee development, performance improvement, and adherence to credentialing standards and best practices.

In addition, this individual will maintain an individual workload and be responsible for preparing correspondence, gathering credentialing documentation, and working with the credentialing vendor to submit applications to insurance organizations for both initial credentialing and recredentialing. The Credentialing Specialist Team Lead will also assist with onboarding new team members, facilitating training initiatives, and helping to establish consistent processes and procedures across the department.

ThePayer Enrollment Team Leadwill coordinate with physicians, practice managers, practice directors, and executive-level leaders. Ultimately, these functions serve to ensure there are no lapses in credentialing and to promote collaboration with our credentialing vendor and Contracting teams to maintain insurance participation and coverage for our providers, patients, and the communities we serve.

Essential Functions:

• Maintain Individual Payer Enrollment Workload
• Day to day guidance, training and support to credentialing specialists
• New Hire Training /Onboarding and Mentoring
• Helping staff members learn new skills and solve daily problems; hands on project support throughout team
• Works with other department managers and staff, including physicians, managed care, contracting, and other professional staff, to acquire necessary materials and information for provider certification and licensure to promote organization-wide compliance with credentialing policies and procedures
• Helps Implement process and organization of all-payer credentialing and re-credentialing paperwork with participating insurance companies by leading by example
• Assists with auditing provider credentialing and enrollment files to ensure accuracy, completeness, compliance with organizational policies, payer requirements, and regulatory standards
• Key liaison with Medical Staff team, outside vendors
• Assists in completing and reviewing applications with practitioners and other applicable staff
• Performs periodic quality assurance reviews and audits of credentialing, enrollment, and provider data files to identify discrepancies, monitor compliance, and support continuous process improvement efforts
• Assist with additional duties, special projects and departmental initiatives as assigned by leadership to support organizational goals, operational efficiency, and continuous process improvement

Minimum/Preferred Qualifications:

Education:

• HS – High School Diploma or GED is required
• AA – Associate of Arts is preferred

Work Experience

At least two years of experience in physician credentialing is required

Knowledge, Skills and Abilities:

• Exemplary problem-solving and conflict-resolution skills
• Detail-oriented
• Skilled in synthesizing a wealth of information
• Exhibits excellent time management and prioritization abilities
• Communicates effectively both one-on-one and in a group setting
• Capable of following and providing detailed instructions both orally and through written communication
• Experience with credentialing database management software preferred
• Extensive experience working with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook, Access, Project)

This job will be fully remote.

Our Billing Co. offers a competitive benefits package!

Pay Range: $30.00 - $32.00

Individual annual salaries/hourly rates will be set within job's compensation range, and will be determined by considering factors including, but not limited to market data, education, experience, qualifications, and expertise of the individual and internal equity considerations.