Payer Enrollment Specialist

Norwood, OH
Contracted
Healthcare
Mid Level

Payer Enrollment Specialist  

Role Summary  

Our client is seeking a Payer Enrollment Specialist to join their team. The Payer Enrollment Specialist will support the billing department while also performing follow-up actions to gather accurate information needed from payers and providers. The ideal candidate is someone who thrives in a fast-paced environment and has excellent organizational and time management skills.  

  

Role Summary  

  • Complete and review provider applications with accuracy and thoroughness  

  • Contact providers for application information when necessary  

  • Contact government agencies and managed care companies to obtain status and resolve discrepancies related to provider applications  

  • Follow up with physicians and assist with completing applications  

  • Ensure timely submissions of all re-appointments and re-credentials, verify all licenses are current, and maintain internal files including copies of current credentials  

  • Follow up and communicate regularly with the hospital administration, billing department, and office managers  

  • Maintain accuracy of and update the CAQH database  

  • All other duties as assigned  

Skills & Experience  

  • High School diploma or its equivalent is required   

  • Minimum of five (5) years of experience in credentialing is required  

  • Excellent computer skills, including Microsoft Word and Excel  

  • Able to work under pressure  

  • Experience working in a hospital setting  

  • Attention to detail and accuracy skills required  

  • Prior experience working with Cactus and Symplr   

  

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