Payor Enrollment Specialist (Contractor) - Remote

Overview

The Payor Enrollment Specialist will be responsible for managing the payor enrollment lifecycle for providers, ensuring proper credentialing and compliance across various health plans.

In Short

• Manage end-to-end payor enrollment lifecycle for providers.
• Review and attest to CAQH profiles.
• Submit and track payor enrollment applications.
• Act as point of contact for enrollment-related escalations.
• Investigate and resolve billing issues.
• Track application progress and manage timelines.
• Build and refine SOPs for workflows.
• Ensure compliance with NCQA and CAQH standards.
• Identify opportunities for efficiency improvements.
• Support growth through implementation of tools and systems.

Requirements

• 2+ years of experience in provider enrollment or credentialing.
• Experience with payor enrollment applications.
• Familiarity with credentialing databases.
• Strong organizational skills and attention to detail.
• Able to manage multiple workflows independently.
• Comfortable in a fast-paced environment.
• Nice to have: Bachelor’s degree in Healthcare Administration or related field.
• Certifications such as CPCS or CPMSM are a plus.

Benefits

• Work remotely from anywhere in the U.S.
• Flexible working hours.
• Opportunity to work in a fast-growing healthcare startup.
• Collaborative team environment.
• Focus on women’s health and midlife wellness.