Provider Enrollment & Payer Contracting Pro

Noble Community Clinics; Stevens Point (WI); On-site; USD 48,000 - 64,000; Full time

Benefits offered by this job

20 days PTO (accrual starts on day one

8 paid holidays

401(k) with up to 5% employer match

Medical, dental, and vision insurance

Employer paid Short- and long-term(dis

Job summary

Noble Community Clinics is seeking an Enrollment & Contracting Specialist to ensure providers and clinic locations stay enrolled with payers and compliant with enrollment and contracting requirements.

The role manages provider/site enrollment, payer contracting, revalidation, and credentialing activities while coordinating with providers, internal teams, payers, and external partners to keep information current and timely.

Qualifications

• Experience in payer enrollment, credentialing, or payer contracting preferred.
• Proficient with Microsoft Office applications.
• Strong organizational skills and attention to detail.
• Strong analytical and problem-solving abilities.
• Excellent time management skills and ability to meet deadlines.
• Strong interpersonal and communication skills.
• CPR certification required within six months of hire.

Responsibilities

• Complete enrollment for new providers with applicable insurance payers and clearinghouses in a timely and accurate manner.
• Utilize Credential Stream to maintain, track, submit, and initiate provider enrollment and demographic information.
• Maintain CAQH proxy access on behalf of providers.
• Track provider, site, and contract renewals and expiration dates to prevent enrollment lapses.
• Coordinate payer revalidations, renewals, and enrollment updates.
• Establish and maintain professional relationships with insurance payer contacts.
• Serve as an organizational contact for payer enrollment and contracting questions and issues.
• Research payer requirements and develop guidelines for new provider and site agreements as needed.
• Monitor payer requirements and communicate changes to appropriate internal departments.
• Track, research, and assist with resolving enrollment-related denials, adjustments, and payer issues.
• Assist with enrollment-related appeals and payer escalations.

Skills

Payer enrollment

Credentialing

Payer contracting

Communication

Organization

Analytical thinking

Time management

Detail oriented

HIPAA compliance

Education

High school diploma or equivalent

Job description

Noble Community Clinics is seeking an Enrollment & Contracting Specialist to ensure providers and clinic locations stay enrolled with payers and compliant with enrollment and contracting requirements.

The role manages provider/site enrollment, payer contracting, revalidation, and credentialing activities while coordinating with providers, internal teams, payers, and external partners to keep information current and timely.