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Payer Relations Manager Employment: Full-Time, Hourly Location: Maplewood, NJ; Remote Position Company Summary: StationMD is a telehealth company dedicated to serving individuals with intellectual ...

Support payer relations operations through research, analysis, and coordination of managed care contracting activities. * Assist with drafting, reviewing, and maintaining contract documents and ...

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Payer Enrollment Specialist

Payer Enrollment Specialist

StationMD

Maplewood, NJ โ€ข Remote

$20 - $25/hr

Full-time

Posted 7 days ago


Job description

Job Title: Payer Relations Specialist

Reports to: Payer Relations Manager

Employment: Full-Time, Hourly

Location: Maplewood, NJ; Remote Position

Company Summary:

StationMD is a telehealth company dedicated to serving individuals with intellectual and/or developmental disabilities (I/DD). All StationMD clinicians are board-certified and specially trained to treat individuals with I/DD. Clinicians are available 24/7 via telemedicine for urgent and non-urgent medical matters. StationMD also offers scheduled psychiatry visits via telemedicine to individuals with I/DD. In providing this suite of services, StationMD enables individuals with I/DD faster access to high-quality care and substantially reduces unnecessary medical costs.

Position Summary:

We are seeking a Payer Enrollment Specialistโ€ฏto assist with the process of enrolling healthcare providers with insurance companies,โ€ฏre-credentialing,โ€ฏupdating databases, andโ€ฏproblem-solving enrollment issuesโ€ฏto ensure timely and accurate network participation.โ€ฏ

Responsibilities:

  • Application Management:โ€ฏPrepare and submit initial and renewal credentialing/enrollment applications for providers (physicians, facilities, etc.) with commercial and government payers
  • Follow-Up:โ€ฏProactively track and follow up on application statuses, ensuring timely processing and resolving delays
  • Data Management:โ€ฏMaintain accurate provider data within internal and external portals and databases for contracted and non-contracted payers
  • Liaison:โ€ฏServe as a contact for providers, internal teams, and insurance companies regarding credentialing and enrollment
  • Compliance:โ€ฏEnsure adherence to payer requirements, policies, and regulatory standards
  • Issue Resolution:โ€ฏTroubleshoot contracting processing issues by collaborating cross functionally to develop solutions
  • Monitoring:โ€ฏTrack provider licenses, certifications, and insurance expirations

Qualifications:

  • Associateโ€™s degree or equivalent experience in healthcare or business administration
  • Minimum of 4 years of credentialing and payer enrollment experience
  • Strong understanding of health insurance payors and reimbursement processes
  • Experience with credentialing/payor enrollment tracking software (Medallion or similar system)
  • Excellent written and verbal communication skills
  • Strong organizational and follow-up skills
  • Ability to analyze data and identify trends
  • Excellent attention to detail and accuracy
  • Energy and passion for increasing access to quality healthcare and improving the quality of life for individuals with Intellectual and Developmental Disabilities

StationMD is an equal opportunity employer.