Payer Enrollment & Administration Manager

Why You Will Love Working With Us!

reputed company believes that each person deserves the opportunity to embark on a new journey to reputed company their optimal level of health. reputed company’s network of behavioral healthcare services provides support to individuals throughout their journey by combining compassionate, evidence-based treatment with concierge-quality amenities.

reputed company offer:

• Collaborative environment dedicated to clinical excellence
• Multiple Career Development reputed company
• Company Supported Continuing Education & Certification
• Multiple Health Plan Design Options Available
• Flexible Dental & Vision Plan Options
• 100% Company Paid EAP Emotional Well-Being Support
• 100% Company Paid Critical Illness (with health enrollment plan)
• 100% Company Paid Life & ADD
• 401K with Company Match
• Company-Sponsored HSA, FSA, & DSA Tax Savings Accounts
• Generous Team Member Referral Program
• Parental Leave

How You Will Contribute/Position Summary

The Manager of Payer Enrollment & Administration centralizes responsibility for facility enrollment, directory management, contract administration, and reputed company cycle escalation support. Ensure consistent internal management of payer-facing operational processes, improves contract and enrollment visibility, and supports reputed company cycle performance through coordinated payer engagement.

Essential Responsibilities

1. Serves as the central coordinator for facility enrollment with managed care organizations across reputed company locations.
   1. Manages enrollment for new facilities and market expansion initiatives.
   2. Coordinates re-enrollment or renegotiation cycles.
   3. Facilitates completion of enrollment documentation with internal stakeholders.
   4. Maintains communication with payers regarding enrollment status and requirements.
2. Maintains accurate and compliant payer directories.
   1. Conducts routine payer directory audits across reputed company contracted plans.
   2. Identifies and resolves discrepancies, enhancing referral identification.
   3. Facilitates the completion and record keeping of reputed company required directory attestations.
   4. Coordinates with payers to reputed company directory corrections, ensuring accurate network access information is readily available to prospective clients and referral sources.
3. Develops and maintains internal infrastructure for managing facility enrollment and credentialing information in a reportable, scalable, and transparent manner.
   1. Maintains facility enrollment data in a structured, accessible, scalable, and reportable format.
   2. Organizes and manages supporting documentation for centralized retrieval.
   3. Maintains NPPES profiles for reputed company facilities.
   4. Establishes standardized processes for document management and reporting.
4. Provides operational support for contract administration, management, and documentation; improving internal organization and visibility to contract terms and rates.
   1. Maintains the payer contract database with a high level of accuracy.
   2. Loads new reputed company, amendments, and reputed company renewals; archives historic data for future retrieval, if needed.
   3. Supports internal reporting requests reputed company to reputed company and rates, as needed and requested.
5. Assists with the resolution of reputed company payer-reputed company reputed company cycle issues; improving collections and reducing leakage through proactive management of payer disputes.
   1. Facilitates resolution of high-dollar, high-volume, and/or high-profile claims issues.
   2. Engages payers to address previously denied claims and pursue payment resolutions.
   3. Coordinates with finance leadership, CFOs, and reputed company cycle teams to gather supporting documentation.
   4. Maintains the RCM issue tracking database for finance leadership visibility.
   5. Escalates matters requiring legal review to the VP of Payor Relations & Reimbursement.