[Hiring] Payor Enrollment Specialist @Ob Hospitalist Group Corporate

Role Description

The Payor Enrollment Specialist is responsible for processing provider enrollment, credentialing, and re-credentialing applications while maintaining accurate provider records and managing relationships with insurance payors, healthcare facilities, and internal stakeholders. This role requires excellent attention to detail, strong follow-through, and the ability to manage multiple priorities while meeting established turnaround times and quality standards.

Key Responsibilities

• Provider Enrollment & Credentialing
  • Prepare, submit, and track provider enrollment applications for Medicaid, Managed Care, and other insurance payors.
  • Process credentialing and re-credentialing applications for healthcare providers.
  • Manage payer-specific enrollment requirements across multiple facilities and contracts.
  • Monitor credentialing and enrollment application statuses and follow up as needed.
• Provider Data Management
  • Maintain provider credentialing records and databases.
  • Update and manage provider CAQH profiles, licensure information, board certifications, and insurance documentation.
  • Ensure provider rosters remain accurate and current.
  • Maintain CRM records, mail logs, and utility logs.
• Stakeholder Communication
  • Build and maintain professional relationships with providers, payors, hospitals, and credentialing contacts.
  • Respond promptly to credentialing and enrollment requests.
  • Coordinate signature requests and ensure timely completion of required documentation.
  • Escalate unresolved provider documentation issues when necessary.
• Compliance & Quality
  • Ensure all Protected Health Information (PHI) is handled securely and in compliance with company standards.
  • Support compliance initiatives by communicating credentialing issues and status updates appropriately.
  • Meet established accuracy and turnaround-time expectations.
  • Participate in credentialing committee activities as needed.

Qualifications

• High School Diploma or equivalent required.
• 1+ years of payor enrollment experience, specifically with Medicaid and Managed Care payors.
• Strong organizational skills with exceptional attention to detail.
• Excellent verbal communication and professional telephone etiquette.
• Proficiency with Microsoft Office applications, including Word and Excel.
• Ability to manage multiple priorities while maintaining accuracy and meeting deadlines.

Requirements

• Some college coursework or equivalent professional experience.
• Understanding of medical terminology.
• CPCS (Certified Provider Credentialing Specialist) certification.
• Experience maintaining provider credentialing databases and CAQH profiles.
• Experience working in healthcare credentialing, enrollment, or revenue cycle operations.

Benefits

• A mission-based company with an amazing company culture.
• Paid time off & holidays so you can spend time with the people you love.
• Medical, dental, and vision insurance for you and your loved ones.
• Health Savings Account (with employer contribution) or Flexible Spending Account options.
• Paid Parental Leave.
• Employer Paid Basic Life and AD&D Insurance.
• Employer Paid Short- and Long-Term Disability.
• Optional Short Term Disability Buy-up plan.
• 401(k) Savings Plan, with ROTH option.
• Legal Plan.
• Identity Theft Services.
• Mental health support and resources.
• Employee Referral program – join our team, bring your friends, and get paid.