Program Coordinator - Payer Connectivity

WellSky Financial Services; United States; On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical Insurance

Dental & Vision

Mental Health support

PTO + Holidays

401(k) Plan

Educational assistance

Job summary

The Program Coordinator - Payer Connectivity at WellSky oversees payer setup, enrollment, and connectivity across multiple EHR and revenue cycle platforms, serving as the subject matter expert for payer architecture and electronic transactions.

The role coordinates end-to-end payer ecosystems supporting electronic claims submission, ERA, EFT, and related processes, ensuring compliance with HIPAA and payer requirements while driving process improvements at the World Head Quarters in Overland

Qualifications

• Bachelor’s Degree or equivalent work experience
• 3–5 years of relevant work experience
• Direct experience with payer enrollment, EDI transactions, clearinghouse operations, and payer connectivity
• Familiarity with process mapping and documentation tools
• Strong working knowledge of Medicare, Medicaid and Commercial Payers
• Working knowledge of healthcare EDI transactions, including: 837 Claims 835 Remittance 277CA Acknowledgments 999 Transactions 270/271 Eligibility

Responsibilities

• Own payer setup, configuration, enrollment, and maintenance across EHR, clearinghouse, and revenue cycle systems.
• Manage electronic claims, ERA, EFT, and trading partner enrollments.
• Support payer onboarding, EDI testing, connectivity validation, and issue resolution.
• Serve as the primary liaison for payer and clearinghouse relationships.
• Partner with cross-functional teams to optimize payer workflows and claims processing.
• Investigate enrollment, connectivity, and claims issues; perform root cause analysis and coordinate resolutions.
• Maintain payer configurations, reporting, and system documentation.
• Ensure compliance with HIPAA, CMS, state, and payer requirements with respect to electronic claims transmission and management processes.

Skills

Payer enrollment

EDI transactions

Payer connectivity

HIPAA compliance

Documentation tools

Education

Bachelor's Degree

Tools

Clearinghouse software

EHR integrations

Job description

The Program Coordinator - Payer Connectivity is responsible for providing program and initiative support across WellSky and serving as the organization's subject matter expert for payer setup, electronic payer enrollment, EDI connectivity, and general payer architecture across multiple Electronic Health Record (EHR) and revenue cycle platforms. This role is responsible for coordinating and maintaining the end-to-end payer ecosystem that supports electronic claims submission, Electronic Remittance Advice (ERA), and related revenue cycle transactions. This role is located onsite at World Head Quarters in Overland Park, Kansas.

Key Responsibilities

Payer Operations & Enrollment Management

• Own payer setup, configuration, enrollment, and maintenance across EHR, clearinghouse, and revenue cycle systems.
• Manage electronic claims, ERA, EFT, and trading partner enrollments.
• Support payer onboarding, EDI testing, connectivity validation, and issue resolution.
• Serve as the primary liaison for payer and clearinghouse relationships.

Revenue Cycle & System Support

• Partner with cross-functional teams to optimize payer workflows and claims processing.
• Investigate enrollment, connectivity, and claims issues; perform root cause analysis and coordinate resolutions.
• Maintain payer configurations, reporting, and system documentation.

Compliance & Process Governance

• Ensure compliance with HIPAA, CMS, state, and payer requirements with respect to general electronic claims transmission and management processes.
• Maintain SOPs, enrollment records, and audit-ready documentation.
• Monitor industry changes and drive process improvements to enhance operational efficiency.

Required qualifications

• Bachelor’s Degree or equivalent work experience
• At least 3-5 years of relevant work experience
• Direct experience with payer enrollment, EDI transactions, clearinghouse operations, and payer connectivity.
• Familiarity with process mapping and documentation tools
• Strong working knowledge of Medicare, Medicaid and Commercial Payers
• Working knowledge of healthcare EDI transactions, including: 837 Claims 835 Remittance 277CA Acknowledgments 999 Transactions 270/271 Eligibility

Job Expectations

• Willing to work additional or irregular hours as needed
• Must work in accordance with applicable security policies and procedures to safeguard company and client information
• Must be able to sit and view a computer screen for extended periods of time #LI-CS1 #LI-Onsite

WellSky is where independent thinking and collaboration come together to create an authentic culture.

We thrive on innovation, inclusiveness, and cohesive perspectives.

At WellSky you can make a difference.

Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky:

• Excellent medical with Rx, dental, and vision benefits
• Mental Health support through EAP
• Generous paid time off, plus 13 paid holidays
• 100% vested 401(K) retirement plans
• Educational assistance up to $2500 per year

WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law.

WellSky is proud to be a drug‑free workplace.

Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States.

Verification of employment eligibility will be required at the time of hire.

Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates.

Data Privacy Notice for Job Applicants and Teammates

WellSky is a technology company leading the movement for intelligent, coordinated care worldwide. Our next‑level software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value‑based care environment, WellSky helps providers, payers, health systems, and community organizations solve tough challenges, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care.