Payer Enrollment Specialist

Posted Yesterday
Hiring Remotely in USA
Remote
60K-70K Annually
Mid level
Healthtech • Other
The Role
The role involves researching, preparing, and submitting health plan enrollment requests, resolving payer-related questions, and maintaining documentation for compliance and efficiency.
Summary Generated by Built In
Join Cartwheel to help tackle the student mental health crisis. 

Cartwheel is an early-stage company building a new kind of mental health program for kids that puts schools at the center. We see our role as supporting school staff who see kids every single day. Instead of going around them, we collaborate with them. This means: 

  • Earlier intervention
  • Higher student and family engagement in care
  • Better coordination among the trusted adults in a student’s life 

Kids shouldn't just aspire to get out of bed and drag themselves to class. They should be able to experience joy. They deserve to envision and build a life they’re excited to live. If you join Cartwheel, you’ll help make this vision a reality for millions of students across the country. We’re backed by top investors including Menlo Ventures, Reach Capital, General Catalyst, BoxGroup, and Able Partners, and we're looking for mission-driven teammates to join our team.

ABOUT THE ROLE

You will work directly with the Director of Health Plan Operations to research, prepare, and submit accurate and timely health plan enrollment requests on behalf of Cartwheel. You’ll also research and resolve payer or client related questions related to submitted enrollments.

Role type: This is a full-time position

Location: 100% remote in the U.S.

WHAT YOU’LL DO
  • Research payer enrollment requirements by state and prepare complete enrollment applications for Medicaid, Medicare commercial, and managed care plans (including all required forms, documentation, and supporting materials)
  • Submit and track group and individual provider enrollment requests from application retrieval through completion notification
  • Follow up with payers and providers via phone, email, and online portals to gather information, resolve questions, and expedite approvals
  • Maintain enrollment trackers and organize payer/provider documentation (NPPES, CAQH, DEA, CDS profiles, etc.) accessible to internal stakeholders
  • Build relationships with payer representatives and contracting departments to streamline submissions and improve approval timelines
  • Process demographic updates and prepare reports on enrollment status as needed
  • Follow all company procedures and meet team performance metrics around enrollment application submissions and credentialing turnaround times
  • Ability to pass a background check without concerns 
  • Other duties as assigned
WHO YOU ARE 
  • 3+ years of experience with payer enrollment applications and processes, including Medicaid and commercial payers (outpatient behavioral health group contracting experience is a plus)
  • Expert with Google Suite tools (Sheets, Docs, Gmail)
  • Strong preference for experience in Salesforce and/or Verifiable
  • Exceptionally detail-oriented with strong organizational skills - you ensure complex enrollment packages are complete and accurate
  • Able to work independently and collaboratively in a fast-paced environment, taking initiative to break down projects and identify process improvements
  • Strong communicator who builds effective relationships with internal teams and external contacts at all organizational levels
WHY YOU’LL LOVE CARTWHEEL

Our hope is that Cartwheel will be your best career decision! In addition to tackling one of the biggest challenges of our time, at a company well-positioned to do so, you’ll have: 

  • Mission-oriented and inclusive colleagues who will go to bat for you
  • Competitive compensation of $60,000-$70,000 dependent on experience
  • Generous PPO medical, vision, and dental coverage
  • Generous paid time off, including company closure from Christmas-New Years (12/25-1/1)
  • Paid parental leave
  • 401K with employer match
  • Meaningful equity ownership stake in Cartwheel
  • Remote role with regular in-person retreats
  • $500 annual learning stipend
  • Macbook

Cartwheel is proud to be an equal opportunity employer. We embrace diverse backgrounds and perspectives and an inclusive work environment. We're committed to equal employment opportunity regardless of race, color, religion, ancestry, national origin, gender, sexual orientation, disability status, or veteran status.

We participate in E-Verify. Please be prepared to provide acceptable documentation to verify your identity and work authorization.

Cartwheel is proud to be an equal opportunity employer. We embrace diverse backgrounds and perspectives and an inclusive work environment. We're committed to equal employment opportunity regardless of race, color, religion, ancestry, national origin, gender, sexual orientation, disability status, or veteran status.

We participate in E-Verify. Please be prepared to provide acceptable documentation to verify your identity and work authorization

Top Skills

Google Suite
Salesforce
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The Company
HQ: Cambridge, Massachusetts
79 Employees
Year Founded: 2022

What We Do

We believe that kids shouldn’t just aspire to get out of bed and drag themselves to class. They should be able to experience joy. They deserve to envision and build a life they’re excited to live.

Cartwheel is the trusted mental health partner to schools. We deliver rapid access to care for students and help schools build stronger mental health programs that catch kids before they fall.

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