Senior Payer Enrollment Specialist

🔥 5 minutes ago

🇺🇸 United States – Remote

💵 $55k - $65k / year

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

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US Fertility

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

🤝 B2B

🔬 Science

Healthcare • B2B • Science

US Fertility is the largest physician-led fertility network in the United States, bringing together reproductive medicine practices to deliver high clinical standards and improved pregnancy rates. The organization provides practice management and laboratory management services to fertility practices, operates a Research Division, runs an Innovation Fund to invest in early-stage fertility-related ventures, and supports academic programs and physician training. US Fertility partners with physician-owned clinics across many locations to scale operations, improve patient outcomes, and expand access to reproductive care.

📋 Description

• Manage initial and recredentialing payer enrollment for groups, facilities, physicians, and APPs across insurance plans • Coordinate the addition of new service locations and maintain accurate payer contract participation • Manage monthly payer roster submissions and maintain efficient enrollment workflows, policies, and procedures • Utilize payer portals, including Availity, UHC, Kaiser, and LexisNexis, to manage enrollment and provider data • Maintain accurate provider, practice, and group information across NPPES, CAQH, payer portals, and directories • Conduct quarterly provider data attestations and validate demographic and participation information • Audit enrollment activities and documentation to ensure accuracy, compliance, and adherence to established processes • Research and resolve payer enrollment issues while ensuring provider information meets payer and organizational requirements • Coordinate malpractice insurance certificates and annual Certificates of Insurance renewals • Support, train, and mentor the payer enrollment team while contributing to departmental initiatives and special projects • Identify and implement process improvements that enhance enrollment efficiency, accuracy, and overall team performance

🎯 Requirements

• An associate degree and three years of payer enrollment experience, or five years of experience in lieu of a degree • Bachelor’s degree preferred • Prefer CPCS, CPES, RHIA, or RHIT certification • CPCS required within two years if not already certified • Knowledge of payer enrollment, provider participation, and applicable regulatory requirements • Proficiency with Microsoft Office, CAQH ProView, NPPES, OIG, and payer portals • Strong attention to detail, organization, and documentation skills • Effective and professional communication with internal and external stakeholders • Ability to maintain confidentiality when handling sensitive provider and organizational information • Ability to research and resolve payer enrollment and provider data issues effectively • Ability to manage multiple priorities and deadlines in a fast-paced environment • Strong customer service, problem-solving, teamwork, and adaptability • Monday through Friday availability from 7:30 AM to 4:30 PM Eastern Time

🏖️ Benefits

• Medical, dental, and vision insurance • 401(k) with company match • Tuition assistance and professional development support • Performance-based bonus opportunities • Generous paid time off • Paid holidays • Paid parental leave • Life and disability benefits • Fertility Discount Program • Employee wellness and recognition programs

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