Payor Enrollment Data Specialist - Credentialing & Insights

Valley Health System; Paramus (NJ); On-site; USD 74,000 - 93,000; Full time

Benefits offered by this job

Medical / Vision discount

Life Insurance

FSA & Commuter

Disability insurance (short/long)

Paid holidays & PTO

Retirement plan

Tuition assistance

EAP

Fitness center discounts

Day care discounts

Job summary

Valley Health System is seeking a Payor Enrollment Specialist to manage and monitor enrollment activities for VMG, including initial enrollment and re-credentialing of providers with governmental and managed care plans. You will coordinate with providers, payers, the medical staff office, and credentialing partners to ensure data integrity and timely processing.

Responsibilities include initiating enrollment applications, performing provider re-validation, maintaining payer rosters, and

Qualifications

• College degree required.
• 3+ years in provider enrollment or payer credentialing.
• Strong Excel skills required.

Responsibilities

• Manage and monitor payor enrollment activities for VMG, including initial enrollment and re-credentialing of providers into governmental and managed care plans.
• Initiate enrollment applications, provider re-validation, payer roster maintenance and credentialing support with providers, payers, medical staff office and delegated credentialing partners.
• Maintain Provider Enrollment data integrity including auditing and roster maintenance across systems and payer portals.
• Provide reporting and information to support the Department Manager's oversight of enrollment, credentialing and payer-related operational activities.

Skills

Interpersonal skills

Analytical skills

Communication skills

Organizational skills

Time management

Independence & teamwork

Problem-solving

Judgment

Education

College degree

Tools

Excel

Job description

Valley Health System is seeking a Payor Enrollment Specialist to manage and monitor enrollment activities for VMG, including initial enrollment and re-credentialing of providers with governmental and managed care plans. You will coordinate with providers, payers, the medical staff office, and credentialing partners to ensure data integrity and timely processing.

Responsibilities include initiating enrollment applications, performing provider re-validation, maintaining payer rosters, and