Payer Operations Specialist

Babylist

1d • $85,075 - $102,090 • Remote

About The Position

The Payer Operations Specialist will be responsible for the operational backbone of payer contracting across Medicaid and commercial payers at Babylist Health. This role ensures that payer contracts, licenses, and credentials are submitted accurately, loaded on time, maintained in good standing, and fully operational prior to go-live. This role is critical to enabling scale—reducing operational friction, minimizing controllable denials and AR, and ensuring Babylist Health captures the full value of newly won payer contracts. You'll be joining a scrappy, collaborative team that's building the Medicaid and commercial payer strategy from the ground up, with the opportunity to define processes and bring order where it doesn't yet exist.

Requirements

• You have 3–6+ years of experience in payer operations, credentialing, or healthcare contracting
• You have experience across both Medicaid and commercial payers (strongly preferred)
• You're highly detail-oriented with strong project management skills and can manage multiple payer uploads and deadlines simultaneously
• You have strong cross-functional communication skills and can translate complex payer requirements for non-expert audiences
• You're scrappy and resourceful—when a payer contact goes radio silent, you find creative ways to get the information you need
• You thrive in startup environments where you can build processes from scratch and aren't afraid of ambiguity
• You're comfortable and enthusiastic about working in an AI-forward environment where AI tools are part of daily operations
• You embrace using technology to enhance your work while keeping people at the center

Responsibilities

• Maintain detailed documentation and renewal schedules for licenses, credentials, and payer requirements
• Own requirements for and execution of site inspections across multiple office locations
• Coordinate responses to payer and regulatory requests for information in the event of an audit or otherwise
• Own the end-to-end payer onboarding process, ensuring payers are fully loaded prior to effective dates
• Partner with Billing and Ops teams to ensure claims and billing workflows are configured correctly, EFT and remittance are set up, authorization and denial management processes are in place, and reimbursement rates are clearly articulated
• Act as the operational point of contact during payer go-lives
• Maintain ongoing compliance and good standing across 85+ payer contracts
• Support contract amendments, renewals, and updates
• Track payer performance indicators such as rejections/denials, AR aging, patient responsibility, and cancellation rates, escalating issues as needed
• Work closely with Payer Leads, Legal, Finance, Billing, Ops, and CS teams
• Ensure payer requirements are clearly documented and communicated internally
• Support rate change implementations and contract conversions from third-party to direct relationships

Benefits

• Competitive pay and meaningful opportunities for career advancement
• We believe technology and data can solve hard problems
• We're committed to career progression and performance-based advancement
• Competitive salary with equity and bonus opportunities
• Company-paid medical, dental, and vision insurance
• Retirement savings plan with company matching and flexible spending accounts
• Generous paid parental leave and PTO
• Remote work stipend to set up your office
• Perks for physical, mental, and emotional health, parenting, childcare, and financial planning

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 251-500 employees