Associate Director, Payer Enrollment - Remote

Overview

The Associate Director, Payer Enrollment is responsible for facilitating the enrollment program and serves as the primary enrollment liaison for clinics, payers, billing office, and practitioner related issues.

In Short

• Ensure protocols for timely resolution and completion of payer enrollment.
• Assure compliance with health plan requirements for provider certification.
• Streamline processes for the onboarding department using automation.
• Provide updates and resolve complex provider enrollment issues.
• Develop tools and procedures for auditing and reporting.
• Oversee special projects related to health plan requirements.
• Interact effectively with management and physician office staff.
• Maintain up-to-date data for providers in credentialing databases.
• Mentor and train new and existing staff.
• Coordinate and prepare reports on credentialing statistics.

Requirements

• 7+ years’ experience in managed care credentialing or billing.
• Experience leading Enrollment teams with large provider inventory.
• Strong problem-solving and analytical skills.
• Intermediate/advanced Microsoft Excel skills.
• Experience with Verity CredentialStream preferred.
• Athena EMR experience preferred.
• Experience supporting Medicare/Medicaid required.
• Knowledge of NCQA guidelines preferred.
• Ability to function independently and manage multiple projects.
• Compliance with HIPAA rules and regulations.

Benefits

• Annual bonus targeted at 15%.
• Restricted stock units.
• Medical, dental, vision, and life insurance.
• 401K plan.
• Paid time off and wellness programs.