Payer Enrollment Specialist

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $35k - $58k / year

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

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Guidehouse

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2018

🏥 Healthcare

🎖️ Defense

📦 Logistics

💰 Grant on 2023-02

Healthcare • Defense • Logistics

Guidehouse is a global consultancy offering advisory, digital, and managed services across commercial and public sectors. It is purpose-built to support industries such as national security, financial services, healthcare, energy, and infrastructure. Guidehouse collaborates with leaders to navigate complexity and drives transformational changes that impact the future. Their expertise spans data analytics, digital technologies, risk management, and more, with a strong emphasis on sustainability and innovation.

📋 Description

• Complete and manage payer applications for initial enrollment and re-enrollment • Ensure compliance with organizational standards and regulatory requirements • Coordinate with insurance payers to maintain accurate provider enrollment records for government and commercial payers • Develop and distribute monthly delegated provider rosters • Collaborate with the medical credentialing team on provider enrollments and terminations • Serve as a point of contact for payer enrollment inquiries and issues • Identify and resolve enrollment-related issues with insurance payers • Enter, maintain, and update provider information in payer enrollment systems • Use MD-Staff or similar software to track application statuses and follow up on pending requests • Update tracking spreadsheets and provide enrollment reports to leadership and stakeholders • Ensure active providers are enrolled with relevant payers • Submit timely updates for provider terminations and other changes • Generate reports on enrollment progress, compliance, and delegated roster updates • Recommend process improvements and complete assigned duties supporting payer enrollment operations

🎯 Requirements

• High School Diploma / GED or 3 years of relevant equivalent experience in lieu of Diploma / GED • 1-3+ year's experience in office, business, operations, customer service or healthcare field • Operational experience with MD-Staff or other payer enrollment software • Experience with delegated roster management for insurance payers

🏖️ Benefits

• Medical, Rx, Dental & Vision Insurance • Personal and Family Sick Time & Company Paid Holidays • Position may be eligible for a discretionary variable incentive bonus • Parental Leave • 401(k) Retirement Plan • Basic Life & Supplemental Life • Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts • Short-Term & Long-Term Disability • Tuition Reimbursement, Personal Development & Learning Opportunities • Skills Development & Certifications • Employee Referral Program • Corporate Sponsored Events & Community Outreach • Emergency Back-Up Childcare Program • Flexible benefits package