Payer Operations Specialist
A
AllaraWomen's Health
Remote (US)Full-TimeMiddle
Salary$55,000 - $65,000
Apply NowOpens the employer's application page
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 experience performing persistent follow-ups with payers.
- Exceptional attention to detail and organizational skills.
- Experience with payer portals and third-party portals (e.g., Availity) preferred.
- Familiarity with commercial payer requirements (Medicare/Medicaid a plus).
- Experience in multi-state telehealth or high-growth healthcare environments preferred.
- 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 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 secure approvals.
- Partner with RCM and business development teams on strategic payer initiatives.
- Assist with application submission as needed.
View Full Description & ApplyYou'll be redirected to the employer's site
