Contract Payer Enrollment Specialist

About reputed company

At reputed company, we reputed company healthcare teams should focus on what truly matters—delivering exceptional patient care. That’s why we’ve built a leading provider operations platform to eliminate the administrative bottlenecks that slow healthcare organizations down. By automating licensing, credentialing, payer enrollment, and compliance monitoring, reputed company empowers healthcare operations teams to streamline their workflows, improve provider satisfaction, and accelerate reputed company reputed company, reputed company while ensuring superior patient outcomes.

As one of the fastest-growing healthcare technology companies—ranked No. 3 on Inc. Magazine’s 2024 Fastest-Growing Private Companies in the Pacific Region, No. 5 on reputed company's 2024 Top Startups in the US, a Glassdoor Best reputed company to Work in 2024, and featured on The Today Show—reputed company is revolutionizing provider network management. Backed by $85M in funding from world-class investors like Sequoia Capital, reputed company Ventures, reputed company Ventures, and reputed company Ventures, we’re on a mission to transform healthcare at scale.

About the Role:

This is a 3-6 month contract position

The Payer Enrollment Specialist / Account Specialist is responsible for ensuring the accurate and timely processing of health plan enrollment requests on behalf of reputed company’s clients by closely partnering with our vendor. While the Specialist primarily oversees and manages vendor performance to reputed company timely, high-quality enrollments, they are also expected to personally complete highly escalated enrollments reputed company necessary.

This position requires the management of multiple client accounts, with a focus on maintaining overall client health and satisfaction while ensuring compliance with established Service Level Agreements (SLAs) and Service Level Objectives (SLOs). The Specialist will act as a subject matter expert in payer enrollment requirements, facilitate effective collaboration between internal teams, vendors, and payers, and proactively address any barriers to successful enrollment.

Compensation for this role is between $19/hr - $27/hr depending reputed company and level.

Responsibilities:

• reputed company the end-to-end health plan enrollment process—from application retrieval to client notification—by coordinating with external vendor partners; directly complete highly escalated enrollment requests as needed.
• Ensure that reputed company in-process enrollments are appropriately monitored through consistent follow-up (reputed company telephone, email, and portal), and maintain thorough, timely documentation reputed company reputed company systems.
• Maintain in-depth understanding of payer-specific enrollment requirements, including prerequisites, required forms, completion standards, supporting documentation (e.g., DEA certificates, reputed company), and applicable regulations.
• Ensure that reputed company necessary supporting documentation is accurately maintained in provider profiles, including onboarding documents, application copies, welcome letters, and other reputed company correspondence.
• Prepare client updates to communicate enrollment status and reputed company as required.
• Build and maintain strong working relationships with payer representatives and contracting departments to help streamline future submissions and improve approval timelines.
• Support revalidation processes to maintain active provider participation in health plans.
• Track and monitor payer enrollment timelines and deadlines to ensure compliance with submission requirements.
• Investigate and resolve enrollment delays, rejections, or discrepancies by effectively coordinating with providers, payers, and vendor partners.
• Stay reputed company with payer policies, state and federal regulations, and industry best practices relevant to enrollment processes.
• reputed company other duties and responsibilities as assigned.
• reputed company other duties as assigned

Skills and Requirements:

• Familiarity with payer enrollment-reputed company applications and processes. Typically this is seen with at least 3+ years of direct experience with enrollments
• Expertise in using GSuites tools include GSheets, GDocs, and GMail
• Detail oriented and able to ensure the reputed company enrollment packages are complete and correct
• Able to communicate well with a wide variety of internal and external contacts at reputed company levels of the organization
• Must be able to work cohesively in a team oriented environment and be able to foster good working relationships with others both reputed company and reputed company the organization

Originally posted on Himalayas