Payer Operations Specialist
A
Allara HealthWomen's Health
Remote (US)Full-TimeMiddle
Salary$55,000 - $65,000 with opportunities for advancement
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Job Details
- Experience
- 2+ years of experience in provider enrollment, credentialing, payer contracting, or healthcare administration
Requirements
- 2+ years of experience in provider enrollment, credentialing, payer contracting, or healthcare administration.
- Demonstrated experience building or documenting processes and SOPs.
- Comfort owning metrics and reporting on pipeline throughput.
- Highly independent and driven with ability to follow up relentlessly.
- Exceptional attention to detail and organizational skills.
- Hands-on experience with payer portals and third-party portals (e.g., Availity).
- Familiarity with commercial payer requirements (Medicare and Medicaid processes are a plus).
- Experience in multi-state telehealth, digital health, or high-growth healthcare environments.
- Exposure to credentialing standards such as NCQA or CMS.
Responsibilities
- Document and maintain end-to-end SOPs for payer contracting, enrollment, and credentialing workflows.
- Implement quality controls and error-catching checkpoints to reduce rework and rejected applications.
- Identify bottlenecks in the expansion pipeline and drive cycle-time improvements.
- Maintain enrollment and contracting trackers, flag delays, and escalate blockers with proposed solutions.
- Conduct proactive follow-up with payers via phone, email, and portals to resolve deficiencies and push applications to approval.
- Partner with RCM and payer strategy teams on collaborative problem-solving and strategic initiatives.
- Assist with application submission as needed.
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