Payer Enrollment & Contracting Specialist

Third Street Community Clinic Inc•Mansfield, OH

21h

About The Position

We're looking for a driven and detail-oriented professional to join our team as a Provider Enrollment & Payer Operations Specialist. In this role, you'll play a vital part in ensuring providers and services remain accurately enrolled, contracted, and configured across payer systems so that claims process correctly and revenue flows without disruption. You will serve as a key connector between enrollment, contracting, credentialing, billing, and IT systems—helping maintain the infrastructure that keeps our revenue cycle running smoothly. The ideal candidate is highly organized, systems-minded, and comfortable managing complex, multi-step processes with accuracy and accountability. They value continuous learning, take ownership of their work, and thrive in environments where precision, follow-through, and cross-functional collaboration are essential. Most importantly, they are passionate about strengthening operational foundations that support sustainable healthcare delivery and stronger communities.

Requirements

Bachelor’s degree in Healthcare Administration, Business, or related field (or equivalent experience) preferred.
3–5+ years of experience in payer enrollment, credentialing, contracting coordination, or revenue cycle operations.
Strong working knowledge of Medicare, Medicaid, and commercial payer enrollment and revalidation processes.
Experience with payer portals and clearinghouse systems required.
Demonstrated ability to manage complex, multi-step processes with high accountability.
Experience in FQHC or similar healthcare setting strongly preferred.

Responsibilities

Own the full lifecycle of provider, facility, and service enrollment across Medicare, Medicaid, and commercial payers.
Coordinate closely with external enrollment vendors to ensure accurate, timely, and complete submissions.
Manage payer contracting activities including new agreements, renewals, amendments, and terminations.
Maintain and update payer portals, ensuring accurate provider data, user access, and system configuration.
Oversee clearinghouse setup and maintenance to ensure proper claim routing and payer connectivity.
Track and complete all payer revalidations to ensure continuous enrollment and prevent lapses in billing.
Serve as the internal subject matter expert on payer enrollment, contracting, and system setup impacts on revenue cycle operations.
Partner with billing, credentialing, IT, and operations teams to resolve enrollment or configuration-related claim issues.