Manager, Payer Enrollment - Remote

Overview

The Manager, 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 are being followed for timely resolution of payor enrollment.
• Assure compliance with health plan requirements.
• Streamline processes and workflows for the on-boarding department.
• Provide regular updates and resolve complex provider enrollment issues.
• Develop tools and procedures for auditing and reporting.
• Oversee special projects related to health plan requirements.
• Maintain up-to-date data for each provider in credentialing databases.
• Mentor and train new and existing staff.
• Coordinate and prepare reports on credentialing statistics.
• Record and track credentialing statistics.

Requirements

• 5+ years’ experience in managed care credentialing or billing.
• Experience leading Enrollment teams with large provider inventory.
• Strong problem-solving skills and analytical abilities.
• 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.
• Must comply with HIPAA regulations.

Benefits

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