Payer Operations Specialist

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $55k - $65k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

⚙️ Operations

🚫👨‍🎓 No degree required

👻 Ghost score 20%

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Allara

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2020

💼 Consulting

🛡️ Insurance

🏥 Healthcare

💰 $26M Series B - Allara on 2025-01

Consulting • Insurance • Healthcare

<Allara> Allara is a telehealth women’s specialty care platform that provides personalized, team-based medical and nutrition care for complex hormonal, metabolic, and gynecological conditions. Through virtual visits, board-certified OB-GYNs, endocrinologists, nurse practitioners, registered dietitians, and care concierges, Allara delivers comprehensive testing, individualized treatment plans, and ongoing monitoring, with insurance-supported or self-pay options.

📋 Description

• Serve as a subject matter expert and payer escalations contact on the credentialing and payer operations team • Document and maintain end-to-end SOPs for payer contracting, enrollment, and credentialing workflows • Implement quality controls and error-catching checkpoints to reduce rework and rejected applications • Identify bottlenecks in the expansion pipeline and drive cycle-time improvements • Maintain enrollment and contracting trackers, flag aging items and delays, and escalate blockers with proposed solutions • Follow up with payers via phone, email, and payer portals to confirm application receipt, resolve deficiencies, and push applications through approval • Own each application item through completion • Partner with RCM and payer strategy/business development teams on collaborative problem-solving and strategic payer initiatives • Assist with application submission as needed

🎯 Requirements

• 2+ years of experience in provider enrollment, credentialing, payer contracting, or healthcare administration (internship or adjacent revenue cycle experience considered) • Demonstrated experience building or documenting processes and SOPs • Comfort owning metrics and reporting on pipeline throughput • Highly independent and driven • Comfort calling and escalating within payer networks • Ability to manage own queue without reminders • Exceptional attention to detail and organizational skills • Experience with payer portals and third-party portals such as Availity (preferred) • Familiarity with commercial payer requirements; understanding Medicare and Medicaid processes is a plus (preferred) • Experience in multi-state telehealth, digital health, or a high-growth healthcare environment (preferred) • Exposure to credentialing standards such as NCQA and CMS (preferred)

🏖️ Benefits

• Equity • Professional development & employee learning programs • Comprehensive health benefits (medical, dental, vision) • Generous paid time off • Additional wellness and professional development perks • 100% remote within the U.S. • Unlimited PTO & 11 company holidays • Health Savings Account (HSA) & Flexible Spending Account (FSA) • Long- and short-term disability coverage • Annual employee wellness stipend • 401(k) plan • Parental leave & family planning support benefits • Company-issued laptop • Annual work-from-home stipend • Commuter benefits (if applicable) • Collaborative, mission-driven culture focused on improving patient care