Payor Enrollment Specialist
symplr
Payor Enrollment Specialist
- ID
- 2025-2039
- Category
- Credentialing
- Position Type
- Regular Full-Time
- Min
- USD $17.00/Hr.
- Max
- USD $20.00/Hr.
Overview
The Payor Enrollment Specialist is responsible for provider enrollment into Federal, State, and commercial health plans, correspondence with provider's office, gathering of provider data needed for enrollment, completion of provider applications and follow-up with health plans until provider is fully enrolled. Also, responsible for advising the provider's office concerning best practices and procedures pertaining to enrollment.
Duties & Responsibilities
- Communicate & advise designated contact person of the paperwork necessary to begin the application process for new providers, including any necessary research to gather all details to appropriately enroll provider.
- Communicate & advise the provider or designated contact person of the sequential steps needed to begin the enrollment process, through completion and set timeline expectations.
- Maintain contact with designated contact person to obtain application signatures, and collect all required documents to include with the completed applications.
- Key all provider demographics & enrollment data into software system.
- Scan all related enrollment documents and applications into software system.
- Contact health plans to request provider enrollment application packages and/or required action for enrollment and continue follow-up with insurance plans by telephone or email until all provider numbers are issued.
- Prepare & distribute Payor Affiliation Reports and Status Notesto designated contact person(s) for each provider every 2-3 weeks in order to communicate the progress of approved provider numbers.
- Ability to interact positively in a team environment, demonstrating superior teamwork skills.
- Any other assigned responsibilities as requested by Supervisor, not specifically noted above.
- Prepare and submit monthly invoices in accounting software showing new work and completed work.
Skills Required
- Exceptional organizational abilities
- Strong verbal and written communication skills
- Positive and proactive attitude
- High attention to detail
- Effective critical thinking and problem-solving capabilities
- Proven ability to prioritize multiple projects and tasks
- Ability to exercise sound judgment
- Ability to work independently and manage assigned projects with minimal supervision
- Ability to manage time without immediate supervision
- Self-motivated and goal-oriented
Qualifications Required:
- Completion of 1–2 years of college coursework or equivalent professional experience.
- Prior payor enrollment experience preferred
- Experience in Microsoft Office Suite, including Outlook, Excel (VLOOKUP), and Word, as well as experience with PDF tools such as Adobe Acrobat or Foxit.
Min
Max
Options
The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor.
Applicants must be authorized to work in the U.S. on a full-time basis without the need for current or future sponsorship.
About symplr:
symplr is revolutionizing healthcare operations with a first-of-its-kind platform that drives effective, efficient, and connected workflows while increasing operational benefits and scaling clinical, financial, and quality outcomes—driving value where it matters most.
We are a remote-first company with employees working across the United States, India, and the Netherlands. Guided by values, we focus on teamwork, championing our customers, being rooted in action and outcomes, overcoming challenges, and leading through equality and integrity. Read more about symplr's culture and values at symplr.com/careers.
Perks & Benefits:
- Company Sponsored Medical, Dental & Vision
- Safe Harbor 401K with Employer Matching up to 5%, eligible upon hire with immediate vesting
- HSA Employer Contributions, Employer Paid Life, Short-term and Long-term Disability, and AD&D Insurance Plans
- Permissive Time Off Plans, Volunteer Time Off, & 12 Paid Holidays
- Fully Paid Medical Leaves of Absence and Bonding Leaves for new parents
- Tuition Assistance & Continuing Education Reimbursement available
- Additional Employer-Paid Programs: Cleo Family Services, Care@Work Memberships, Headspace Memberships, LifeMart Discounts, and more!
symplr is an Equal Opportunity/Affirmative Action Employer. We consider applicants without regard to race, color, religion, age, national origin, ancestry, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, veteran status, disability, genetic information, citizenship status, or membership in any other group protected by federal, state or local law.
As an ongoing commitment to reasonably accommodate individuals with disabilities, symplr has established alternative methods to complete the application process. Disabled applicants needing assistance are encouraged to call 281.863.9500 if further assistance is required.
To all recruitment agencies: we do not accept resumes or partnership opportunities. Please do not forward resumes to symplr or any of our employees. We are not responsible for any fees related to unsolicited resumes.
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