Payer Enrollment Specialist

Payer Enrollment Specialist  

Role Summary

Our client is seeking a Payer Enrollment Specialist to join their team. The Payer Enrollment Specialist will support the billing department while also performing follow-up actions to gather accurate information needed from payers and providers. The ideal candidate is someone who thrives in a fast-paced environment and has excellent organizational and time management skills.

Role Summary  

• Complete and review provider applications with accuracy and thoroughness

• Contact providers for application information when necessary

• Contact government agencies and managed care companies to obtain status and resolve discrepancies related to provider applications

• Follow up with physicians and assist with completing applications

• Ensure timely submissions of all re-appointments and re-credentials, verify all licenses are current, and maintain internal files including copies of current credentials

• Follow up and communicate regularly with the hospital administration, billing department, and office managers

• Maintain accuracy of and update the CAQH database

• All other duties as assigned

Skills & Experience

• High School diploma or its equivalent is required

• Minimum of five (5) years of experience in credentialing is required

• Excellent computer skills, including Microsoft Word and Excel

• Able to work under pressure

• Experience working in a hospital setting

• Attention to detail and accuracy skills required

• Prior experience working with Cactus and Symplr