Manage organizational and provider credentialing processes * Set up and maintain CAQH profiles * Assist with NPI registration (individual and organizational) * Coordinate payer enrollment and ...
Manage organizational and provider credentialing processes * Set up and maintain CAQH profiles * Assist with NPI registration (individual and organizational) * Coordinate payer enrollment and ...
Pharmacy Technician, Specialty Pharmacy | Call Center | Hybrid
Newark, DE · On-site
$17 - $20.75/hr
... enrollment in patient assistance programs to improve affordability of specialty medication therapy. * Facilitates processing of third-party payer prior authorization (PA) and utilization management ...
Pharmacy Technician, Specialty Pharmacy | Call Center | Hybrid
Newark, DE · On-site
$17 - $20.75/hr
... enrollment in patient assistance programs to improve affordability of specialty medication therapy. * Facilitates processing of third-party payer prior authorization (PA) and utilization management ...
Pharmacy Technician, Specialty Pharmacy | Call Center | Hybrid
Newark, DE · Hybrid
$17 - $20.75/hr
... enrollment in patient assistance programs to improve affordability of specialty medication therapy. * Facilitates processing of third-party payer prior authorization (PA) and utilization management ...
Pharmacy Technician, Specialty Pharmacy | Call Center | Hybrid
Newark, DE · Hybrid
$17 - $20.75/hr
... enrollment in patient assistance programs to improve affordability of specialty medication therapy. * Facilitates processing of third-party payer prior authorization (PA) and utilization management ...
Pharmacy Technician, Specialty Pharmacy | Call Center | Hybrid
Newark, DE · On-site
$17.25 - $20.75/hr
... enrollment in patient assistance programs to improve affordability of specialty medication therapy. * Facilitates processing of third-party payer prior authorization (PA) and utilization management ...
Pharmacy Technician, Specialty Pharmacy | Call Center | Hybrid
Newark, DE · On-site
$17.25 - $20.75/hr
... enrollment in patient assistance programs to improve affordability of specialty medication therapy. * Facilitates processing of third-party payer prior authorization (PA) and utilization management ...
Pharmacy Technician II | Specialty Pharmacy | Hybrid Position
Newark, DE · On-site
$21.03 - $31.50/hr
... and payers to support timely access to therapy * Facilitate patient enrollment in financial ... Manage assigned worklists and tracking systems, ensuring adherence to turnaround time expectations
Pharmacy Technician II | Specialty Pharmacy | Hybrid Position
Newark, DE · On-site
$21.03 - $31.50/hr
... and payers to support timely access to therapy * Facilitate patient enrollment in financial ... Manage assigned worklists and tracking systems, ensuring adherence to turnaround time expectations
Pharmacy Technician II | Specialty Pharmacy | Hybrid Position
Newark, DE · Hybrid
$21.03 - $31.50/hr
... and payers to support timely access to therapy * Facilitate patient enrollment in financial ... Manage assigned worklists and tracking systems, ensuring adherence to turnaround time expectations
Pharmacy Technician II | Specialty Pharmacy | Hybrid Position
Newark, DE · Hybrid
$21.03 - $31.50/hr
... and payers to support timely access to therapy * Facilitate patient enrollment in financial ... Manage assigned worklists and tracking systems, ensuring adherence to turnaround time expectations
... payer, and organizational requirements governing Financial Management Services programs. * Conducts routine and targeted audits of participant, attendant, payroll, enrollment, compliance, and ...
... payer, and organizational requirements governing Financial Management Services programs. * Conducts routine and targeted audits of participant, attendant, payroll, enrollment, compliance, and ...
Patient Services Representative
Wilmington, DE · On-site
$17 - $21.50/hr
Verify and update patient demographic and payer information in electronic medical record system ... Demonstrates outstanding professional telephone management skills * Assists patients who have ...
Patient Services Representative
Wilmington, DE · On-site
$17 - $21.50/hr
Verify and update patient demographic and payer information in electronic medical record system ... Demonstrates outstanding professional telephone management skills * Assists patients who have ...
Patient Services Representative
Wilmington, DE · On-site
$17 - $21.50/hr
Verify and update patient demographic and payer information in electronic medical record system ... Demonstrates outstanding professional telephone management skills * Assists patients who have ...
Patient Services Representative
Wilmington, DE · On-site
$17 - $21.50/hr
Verify and update patient demographic and payer information in electronic medical record system ... Demonstrates outstanding professional telephone management skills * Assists patients who have ...
Patient Services Representative
$17 - $21.50/hr
Verify and update patient demographic and payer information in electronic medical record system ... Demonstrates outstanding professional telephone management skills * Assists patients who have ...
Patient Services Representative
$17 - $21.50/hr
Verify and update patient demographic and payer information in electronic medical record system ... Demonstrates outstanding professional telephone management skills * Assists patients who have ...
Patient Services Representative
Wilmington, DE · On-site
$17 - $21.50/hr
Verify and update patient demographic and payer information in electronic medical record system ... Demonstrates outstanding professional telephone management skills * Assists patients who have ...
Patient Services Representative
Wilmington, DE · On-site
$17 - $21.50/hr
Verify and update patient demographic and payer information in electronic medical record system ... Demonstrates outstanding professional telephone management skills * Assists patients who have ...
Quality Assurance Specialist
Wilmington, DE · Remote
$47K - $57K/yr
... payer, and organizational requirements governing Financial Management Services programs. * Conducts routine and targeted audits of participant, attendant, payroll, enrollment, compliance, and ...
Quick apply
Quality Assurance Specialist
Wilmington, DE · Remote
$47K - $57K/yr
... payer, and organizational requirements governing Financial Management Services programs. * Conducts routine and targeted audits of participant, attendant, payroll, enrollment, compliance, and ...
Payer Enrollment Manager information
What is a payer enrollment manager?
A Payer Enrollment Manager oversees the process of enrolling healthcare providers and organizations with insurance payers to ensure they can bill and receive payments for services rendered. This role involves managing credentialing documentation, maintaining compliance with regulatory requirements, and serving as a liaison between providers and insurance companies. Payer Enrollment Managers help streamline administrative processes, resolve enrollment issues, and keep up with changing payer policies to minimize delays in reimbursement.
What are some common challenges faced by a payer enrollment manager, and how can they be addressed?
Payer Enrollment Managers often encounter challenges such as navigating complex and varying payer requirements, ensuring timely submission of provider information, and managing communication between healthcare providers and insurance companies. Addressing these challenges typically involves staying up-to-date with payer policies, implementing robust tracking systems, and fostering strong relationships with both internal teams and external contacts. Proactive problem-solving and attention to detail are essential to prevent delays and maintain compliance, which ultimately supports smooth operations for the healthcare organization.
What are the key skills and qualifications needed to thrive as a payer enrollment manager, and why are they important?
To thrive as a Payer Enrollment Manager, you need a deep understanding of healthcare provider enrollment processes, regulatory compliance, and experience in medical credentialing, often supported by a bachelor’s degree in healthcare administration or a related field. Familiarity with payer portals, credentialing software, and knowledge of relevant regulations such as CAQH and NPI systems are typically required. Attention to detail, strong organizational skills, and effective communication are essential soft skills for coordinating between providers, payers, and internal teams. These competencies are vital for ensuring timely and accurate provider enrollment, minimizing claim denials, and maintaining compliance within healthcare organizations.
What is the difference between Payer Enrollment Manager vs Payer Credentialing Specialist?
| Aspect | Payer Enrollment Manager | Payer Credentialing Specialist |
|---|---|---|
| Credentials | Typically requires healthcare administration or related certifications, with experience in payer enrollment | Often requires similar credentials, focusing on credentialing and provider verification |
| Work Environment | Manages enrollment processes, liaises with payers, and oversees team activities | Performs credentialing tasks, verifies provider credentials, and maintains provider files |
| Employer & Industry Usage | Common in healthcare organizations, insurance companies, and billing firms | Found in healthcare provider offices, credentialing firms, and insurance companies |
The Payer Enrollment Manager oversees the entire payer enrollment process, managing teams and ensuring compliance, while the Payer Credentialing Specialist focuses on verifying provider credentials and maintaining accurate provider records. Both roles require similar certifications and work within healthcare and insurance settings, but their responsibilities differ in scope and focus.
What are popular job titles related to Payer Enrollment Manager jobs in Delaware?
For Payer Enrollment Manager jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Payer Enrollment Manager jobs in Delaware look for?
The top searched job categories for Payer Enrollment Manager jobs in Delaware are:
What cities in Delaware are hiring for Payer Enrollment Manager jobs?
Cities in Delaware with the most Payer Enrollment Manager job openings:
Healthcare Provider Enrollment & Credentialing Specialist (Volunteer)
Dover, DE • On-site
LoopRoots Foundation
Other
Re-posted 8 days ago
Job description
Title: Healthcare Provider Enrollment & Credentialing Specialist (Volunteer)
Organization: LoopRoots Foundation
Location: Remote
Commitment: 20–25 hours per week
Description:
LoopRoots Foundation is seeking a Healthcare Provider Enrollment and Credentialing Specialist to support the launch of LoopTalk, our HIPAA-compliant virtual mental health program. This role is critical to ensuring our organization is properly enrolled with state Medicaid programs and insurance payers so we can bill for therapy services across multiple states. We are currently preparing for rollout in Arizona, Maryland, Pennsylvania, Virginia, California, and New Mexico. This position will play a key role in helping us become fully operational and revenue-ready.
Responsibilities:
- Complete Medicaid provider enrollment applications across multiple states
- Manage organizational and provider credentialing processes
- Set up and maintain CAQH profiles
- Assist with NPI registration (individual and organizational)
- Coordinate payer enrollment and insurance panel applications
- Track application status, approvals, and revalidation timelines
- Ensure compliance with federal and state healthcare billing requirements
- Help build internal systems for scalable enrollment and credentialing
Qualifications:
- Experience with provider enrollment, credentialing, or healthcare administration
- Familiarity with Medicaid enrollment and insurance payer processes
- Understanding of CAQH, NPI, and healthcare compliance standards
- Strong organizational and tracking skills
- Ability to work independently and meet deadlines
What You’ll Gain:
- Hands-on experience launching a multi-state healthcare program
- Opportunity to transition into a paid role as we scale
- Direct impact on expanding access to mental health services for underserved communities
- Work closely with leadership on a mission-driven initiative
Additional Information:
This is a volunteer position with the potential to transition into a paid role as funding and billing operations are established.