Payer Enrollment Specialist – Contract

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $20 - $28 / hour

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

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Medallion

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2020

⚕️ Healthcare Insurance

☁️ SaaS

🤖 Artificial Intelligence

🔥 Funding within the last year

💰 $43M Series C - Medallion on 2025-08

Healthcare Insurance • SaaS • Artificial Intelligence

Medallion is an AI-powered healthcare operations company that provides a SaaS platform to automate provider credentialing, payer enrollment, licensing, privileging, and ongoing monitoring. The platform uses machine learning and real-time automation to extract and standardize data, manage payer-specific and state rules, run automated follow-ups, and ensure compliance with NCQA and TJC standards—reducing costs and accelerating provider onboarding. Medallion serves payers, provider groups, health systems, RCM organizations, and digital health companies with a focus on lowering administrative burden and improving network readiness.

📋 Description

• Oversee 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 all in-process enrollments are appropriately monitored through consistent follow-up (via telephone, email, and portal), and maintain thorough, timely documentation within Medallion systems. • Maintain in-depth understanding of payer-specific enrollment requirements, including prerequisites, required forms, completion standards, supporting documentation (e.g., DEA certificates, CVs), and applicable regulations. • Ensure that all necessary supporting documentation is accurately maintained in provider profiles, including onboarding documents, application copies, welcome letters, and other related correspondence. • Prepare client updates to communicate enrollment status and progress 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 current with payer policies, state and federal regulations, and industry best practices relevant to enrollment processes. • Perform other duties and responsibilities as assigned.

🎯 Requirements

• Familiarity with payer enrollment-related 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 complex enrollment packages are complete and correct • Able to communicate well with a wide variety of internal and external contacts at all 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 within and outside the organization