Payor Enrollment Specialist- Contract in United States at Jobgether
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Job Description
This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Payor Enrollment Specialist – Contract in the United States.
This role focuses on supporting and scaling provider enrollment operations within a fast-growing virtual care environment. You will be responsible for ensuring that clinicians are accurately credentialed and enrolled with multiple payors, enabling seamless reimbursement and uninterrupted patient care. The position combines hands-on execution with process development, requiring both operational precision and the ability to improve workflows as the organization scales. You will manage enrollment timelines, coordinate with internal teams and external payors, and resolve issues that may impact billing or provider activation. Acting as a key operational link, you will ensure data accuracy, compliance, and efficiency across credentialing systems. This is an excellent opportunity for someone who thrives in detail-oriented healthcare operations within a high-growth, tech-enabled setting.
- Manage the full provider enrollment and credentialing lifecycle across multiple payors for physicians, nurse practitioners, and other clinical staff.
- Review, validate, and maintain CAQH profiles to ensure accuracy, completeness, and compliance with payer requirements.
- Submit, track, and follow up on payor enrollment applications to ensure timely approvals and minimize delays.
- Serve as the primary point of contact for enrollment-related issues, including billing discrepancies and payer escalations.
- Monitor application status, identify risks to timelines, and provide regular updates to internal stakeholders.
- Develop, document, and improve standard operating procedures (SOPs) for credentialing and enrollment workflows.
- Ensure compliance with NCQA, CAQH, and federal/state regulatory requirements while maintaining accurate provider data across systems.
This role requires a detail-oriented healthcare operations professional with strong experience in provider enrollment and credentialing processes. The ideal candidate is highly organized, proactive, and comfortable managing multiple concurrent workflows in a fast-paced environment.
- Minimum 2 years of experience in provider enrollment, credentialing, or licensing.
- Hands-on experience submitting and managing payor enrollment applications across multiple health plans.
- Experience working with healthcare providers, payors, or health systems.
- Familiarity with CAQH and credentialing databases.
- Strong organizational skills with the ability to manage deadlines and multiple priorities independently.
- High attention to detail with strong accuracy in data management and documentation.
- Strong communication and problem-solving skills, especially in resolving enrollment-related issues.
- Ability to work effectively in a high-growth, fast-paced healthcare environment.
- Bachelor’s degree in Healthcare Administration, Business, or related field is a plus.
- Certifications such as CPCS or CPMSM are a plus.
- Contract (1099) opportunity with remote flexibility
- Competitive compensation aligned with experience and scope of work
- Fully remote work environment within the United States
- Opportunity to contribute to a fast-scaling virtual healthcare organization
- Exposure to modern, tech-enabled healthcare operations
- Collaborative and mission-driven team culture
- Flexibility typical of independent contractor arrangements