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Payer Enrollment Specialist JobN/A, N/A

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Why You'll Love This Job

Position Summary:

The Payer Enrollment Specialist is responsible for the initiating, processing, and completing applications/rosters for enrollments of billing providers with the various Government, State, Commercial and Managed Care plans. The person in this role must be well organized and detail oriented, as well as displaying superior time management to ensure all necessary information is entered and completed according to payer guidelines. The ability to multi-task and prioritize requests and workloads is fundamental to the position, so that compliance and payment risks are minimized. 

Essential Job Duties:

  • Manages the completion and submission of CMS Medicare, State Medicaid, MCO and Commercial payer applications/rosters.
  • Contact providers for application information when necessary.
  • Performs tracking and follow up on submitted applications/rosters.
  • Collaborates with Revenue Cycle to research and resolve payer enrollment issues.
  • Complete and submit CMS Medicare and State Medicaid revalidations.
  • Maintain accuracy of CAQH database.
  • Complete any other duties assigned by management. 


  • Work independently to resolve challenges, while seeking assistance when appropriate
  • Ability to lead by example and mentor team members
  • Maintain positive working relationships with colleagues at all levels of the organization
  • Detail oriented, organized and possess a high degree of accuracy
  • Exceptional written and verbal communication skills
  • Familiarity with billing processes
  • Working knowledge of Microsoft Office, Teams and OneView/SharePoint
  • Previous experience with credentialing management software is preferred

Skills & Qualifications

Required Education/Degree:

High School Degree or equivalent related experience 

Required Certification/License: 

Not applicable or required 


Required Work Experience: 

0-1 years, but 1+ year in a medical office/hospital/HR setting preferred 

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

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Job Number: 4931

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