Remote Senior Payer Enrollment Specialist
Insight Global, New York, NY, United States
Job Description
The Senior Payer Enrollment Specialist is responsible for completing accurate and timely health plan enrollment requests on behalf of clients. This role will research and resolve payer or client‑related questions independently with minimal oversight from their lead or manager.
This individual uses a combination of internal proprietary tools and standard communication methods (email, phone, fax, etc.) to complete enrollments. From time to time, a Specialist may interact with clients and internal teams to improve processes and support new tool development.
The role reports to a Payer Enrollment Team Leader.
Responsibilities
Complete health plan enrollment requests from application retrieval through notifying clients upon request completion, including group and individual applications for Medicare, Medicaid, commercial, and managed care health plans.
Understand specific application requirements for each payer, including prerequisites, required forms, form completion requirements, supporting documentation (DEA, CV, etc.), and regulations.
Research payer issues, including new payers and managed care payers, with minimal oversight, and resolve issues quickly and effectively so they do not recur.
Maintain a strong understanding of the Medicaid enrollment process for both individual providers and groups, including revalidations, medical license expirations, deactivations, NPI taxonomy, and complex entity ownership models.
Follow up on enrollments in process via telephone, email, and portal, and maintain enrollment records through timely documentation.
Submit selected applications for audit, working toward 100% accuracy and eliminating the need for any audits for both individual provider and group applications.
Ensure all supporting documentation in provider profiles, including onboarding documents, application copies, welcome letters, and other correspondence.
Create client updates and participate in client calls as needed.
Establish close working relationships with payer representatives and contracting departments to streamline future submissions and improve approval times.
Perform other duties as assigned.
Skills and Requirements
4+ years of payer enrollment experience, including group and individual applications with Medicare, Medicaid, commercial, and managed care health plans.
Detail‑oriented with the ability to ensure complex enrollment packages are complete and correct.
Strong communication skills with a wide variety of internal and external contacts at all levels of the organization.
Ability to work cohesively in a team‑oriented environment and foster good working relationships with others both within and outside the organization.
Expertise in using GSuite tools, including Google Sheets, Google Docs, and Gmail, as well as Adobe Acrobat Pro.
Experience in a fast‑paced, remote, startup‑like environment.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
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This individual uses a combination of internal proprietary tools and standard communication methods (email, phone, fax, etc.) to complete enrollments. From time to time, a Specialist may interact with clients and internal teams to improve processes and support new tool development.
The role reports to a Payer Enrollment Team Leader.
Responsibilities
Complete health plan enrollment requests from application retrieval through notifying clients upon request completion, including group and individual applications for Medicare, Medicaid, commercial, and managed care health plans.
Understand specific application requirements for each payer, including prerequisites, required forms, form completion requirements, supporting documentation (DEA, CV, etc.), and regulations.
Research payer issues, including new payers and managed care payers, with minimal oversight, and resolve issues quickly and effectively so they do not recur.
Maintain a strong understanding of the Medicaid enrollment process for both individual providers and groups, including revalidations, medical license expirations, deactivations, NPI taxonomy, and complex entity ownership models.
Follow up on enrollments in process via telephone, email, and portal, and maintain enrollment records through timely documentation.
Submit selected applications for audit, working toward 100% accuracy and eliminating the need for any audits for both individual provider and group applications.
Ensure all supporting documentation in provider profiles, including onboarding documents, application copies, welcome letters, and other correspondence.
Create client updates and participate in client calls as needed.
Establish close working relationships with payer representatives and contracting departments to streamline future submissions and improve approval times.
Perform other duties as assigned.
Skills and Requirements
4+ years of payer enrollment experience, including group and individual applications with Medicare, Medicaid, commercial, and managed care health plans.
Detail‑oriented with the ability to ensure complex enrollment packages are complete and correct.
Strong communication skills with a wide variety of internal and external contacts at all levels of the organization.
Ability to work cohesively in a team‑oriented environment and foster good working relationships with others both within and outside the organization.
Expertise in using GSuite tools, including Google Sheets, Google Docs, and Gmail, as well as Adobe Acrobat Pro.
Experience in a fast‑paced, remote, startup‑like environment.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
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