Payer Enrollment Specialist - Remote
Northeast Healthcare Recruitment, New York, NY, United States
We are seeking a detail-oriented Payer Enrollment Specialist to manage provider enrollment and payer network participation in a fully remote role. This position plays a critical role in ensuring providers are properly credentialed and enrolled with commercial and government payers, helping maintain compliance and protect reimbursement. The specialist will collaborate closely with internal teams, including Accounts Receivable (AR), to resolve credentialing issues, prevent enrollment-related denials, and support network expansion.
Compensation:
$20-$22 Per Hour
Key Responsibilities
Manage initial and ongoing provider enrollment with commercial and government payers, including credentialing and re-credentialing. Monitor provider enrollment status and proactively address credentialing denials or delays in collaboration with AR and internal teams. Submit new network participation requests to payers to expand provider access and participation opportunities. Ensure timely submission of required documentation to prevent payer terminations and reimbursement disruptions. Serve as a liaison between providers and payers, resolving enrollment issues and clarifying requirements. Maintain accurate records of provider enrollment status, network participation, and payer communications. Identify trends in enrollment or credentialing issues and recommend process improvements. Stay current on payer requirements, regulatory updates, and credentialing best practices. Qualifications:
2+ years of experience in provider enrollment, credentialing, or payer relations. Knowledge of commercial and government payer enrollment processes, credentialing, and re-credentialing. Strong organizational skills with the ability to manage multiple priorities and deadlines. Excellent communication and collaboration skills for working with providers, payers, and internal teams. Detail-oriented with a strong focus on compliance and revenue protection. Proficiency with credentialing platforms such as CAQH or CredentialStream and the Microsoft Office Suite. Experience in healthcare revenue cycle, provider network management, or payer contracting preferred. Familiarity with Medicare, Medicaid, and commercial payer enrollment processes preferred.
Compensation:
$20-$22 Per Hour
Key Responsibilities
Manage initial and ongoing provider enrollment with commercial and government payers, including credentialing and re-credentialing. Monitor provider enrollment status and proactively address credentialing denials or delays in collaboration with AR and internal teams. Submit new network participation requests to payers to expand provider access and participation opportunities. Ensure timely submission of required documentation to prevent payer terminations and reimbursement disruptions. Serve as a liaison between providers and payers, resolving enrollment issues and clarifying requirements. Maintain accurate records of provider enrollment status, network participation, and payer communications. Identify trends in enrollment or credentialing issues and recommend process improvements. Stay current on payer requirements, regulatory updates, and credentialing best practices. Qualifications:
2+ years of experience in provider enrollment, credentialing, or payer relations. Knowledge of commercial and government payer enrollment processes, credentialing, and re-credentialing. Strong organizational skills with the ability to manage multiple priorities and deadlines. Excellent communication and collaboration skills for working with providers, payers, and internal teams. Detail-oriented with a strong focus on compliance and revenue protection. Proficiency with credentialing platforms such as CAQH or CredentialStream and the Microsoft Office Suite. Experience in healthcare revenue cycle, provider network management, or payer contracting preferred. Familiarity with Medicare, Medicaid, and commercial payer enrollment processes preferred.