Remote Payer Enrollment Specialist (Multi-State)

Blue Cloud Pediatric Surgery Centers (trading as Blue Cloud); Phoenix (AZ); Remote; USD 55,000 - 75,000; Full time

Benefits offered by this job

Remote work opportunity

Competitive benefits package

FSA/HSA

401(k) with company match

Paid Time Off (PTO)

Growing team focused on improving care

Job summary

Blue Cloud Pediatric Surgery Centers (trading as Blue Cloud) is seeking a Provider Enrollment Specialist to manage multi-state payer enrollments, recredentialing, and EFT documentation. The role requires strong organization, attention to detail, and the ability to work independently in a remote setting.

You will facilitate initial enrollments, track status, maintain CAQH profiles, and collaborate with Revenue Cycle and Credentialing teams to ensure timely participation across Medicare, Medicaid,

Qualifications

• Minimum of 3 years of payer enrollment experience in a healthcare setting.
• Experience enrolling both individual providers and healthcare entities.
• Strong understanding of payer enrollment requirements, credentialing processes, and provider lifecycle management.
• Experience with multi-state Medicaid enrollments.
• Hands-on experience using CAQH, Availity, and PECOS.
• Strong knowledge of EFT enrollment processes and payer requirements.
• Ability to work independently and drive enrollments from application to approval.
• Excellent organizational skills with exceptional attention to detail.
• Strong problem-solving and critical-thinking abilities.
• Excellent verbal and written communication skills.
• Proficiency in Microsoft Office Suite, including Word and Excel.
• Ability to maintain confidentiality and handle sensitive information appropriately.

Responsibilities

• Facilitate initial enrollments, recredentialing, and payer enrollment applications for providers and entities with Medicare, Medicaid, and commercial insurance plans.
• Prepare, review, and submit enrollment applications, ensuring accuracy, completeness, and timely submission.
• Monitor enrollment application status and conduct proactive follow-up with payers to resolve issues and expedite approvals.
• Establish and maintain strong relationships with payer representatives.
• Document all payer communications and enrollment updates within the credentialing system.
• Maintain accurate provider and entity records, credentialing information, and enrollment data.
• Track enrollment, credentialing, and recredentialing deadlines to prevent interruptions in participation or reimbursement.
• Complete and submit EFT agreements and related payer documentation.
• Maintain and update provider information in payer directories and databases.
• Manage and maintain provider CAQH profiles, ensuring all information remains current and accurate.
• Collaborate with Revenue Cycle, Billing, Credentialing, Operations, and other internal stakeholders to address enrollment-related issues and questions.
• Provide enrollment status updates, reporting, and turnaround-time metrics to leadership.
• Independently prioritize workload and successfully manage multiple enrollments simultaneously.
• Research, troubleshoot, and resolve enrollment barriers with minimal supervision.
• Manage multi-state provider and entity enrollments, including Medicaid enrollments across multiple states.

Skills

Payer enrollment experience

Multistate enrollments

Independent work

Organizational skills

Attention to detail

Communication skills

Microsoft Office

Tools

CAQH

Availity

PECOS

Job description

Blue Cloud Pediatric Surgery Centers (trading as Blue Cloud) is seeking a Provider Enrollment Specialist to manage multi-state payer enrollments, recredentialing, and EFT documentation. The role requires strong organization, attention to detail, and the ability to work independently in a remote setting.

You will facilitate initial enrollments, track status, maintain CAQH profiles, and collaborate with Revenue Cycle and Credentialing teams to ensure timely participation across Medicare, Medicaid,