Remote Payer Relations & Enrollment Specialist

Ovation Healthcare; United States; Remote; USD 70,000 - 100,000; Full time

Job summary

Ovation Healthcare is seeking a Specialist, Payer Relations to guide the provider enrollment lifecycle and advise on billing structure to ensure regulatory and contractual alignment. You will enroll providers with commercial and government payers and maintain accurate provider records.

The role requires 3+ years in provider enrollment or credentialing, strong communication, and attention to detail; proficiency with CAQH, PECOS, Availity, and MS Office is expected.

Qualifications

• Associate or Bachelor's degree in healthcare administration, business, or related field preferred.
• Minimum of 3 years of experience in provider enrollment, payer enrollment, billing, credentialing, or a client-facing healthcare services role.

Responsibilities

• Manage end-to-end provider enrollment process, including initial enrollment, recredentialing, revalidation, and payer contracting readiness.
• Serve as a subject matter expert resource to clients on enrollment requirements, billing processes, payer setup, best practices, and compliance standards.
• Prepare, complete, and submit enrollment applications for individual providers and healthcare facilities across commercial and government payers, including Medicare, Medicaid, and private insurers.
• Maintain accurate and current provider records, including CAQH profiles, NPI registration, state license verifications, payer portal records, and other required documentation.
• Track enrollment status, renewal deadlines, expirations, recredentialing, and revalidation requirements; proactively follow up with payers to support timely processing and approvals.
• Communicate directly with clients, providers, payers, and internal teams to gather required documentation, resolve enrollment-related issues, and elevate barriers when appropriate.
• Update, audit, and maintain provider participation status and demographic data within internal systems and credentialing databases.
• Ensure payer setup and billing configuration meet contractual and regulatory requirements; advise clients on billing structure and enrollment implications.
• Stay current with changes in payer requirements, healthcare regulations, and credentialing standards; apply this knowledge to client recommendations and internal processes.
• Prepare and deliver regular status updates, dashboards, and reports to clients and internal leadership.
• Lead or assist with enrollment audits and support implementation of corrective action plans as needed.

Skills

Enrollment management

Payer enrollment

Credentialing

Client communication

Attention to detail

Remote work

Education

Associate or Bachelor’s degree in healthcare administration, business, or related field

Tools

CAQH

PECOS

Availity

MS Office

Job description

Ovation Healthcare is seeking a Specialist, Payer Relations to guide the provider enrollment lifecycle and advise on billing structure to ensure regulatory and contractual alignment. You will enroll providers with commercial and government payers and maintain accurate provider records.

The role requires 3+ years in provider enrollment or credentialing, strong communication, and attention to detail; proficiency with CAQH, PECOS, Availity, and MS Office is expected.