Payer Relations Specialist

StationMD • Maplewood, NJ

1d

About The Position

We are seeking a Payer Relations Credentialing Associate to assist with the process of enrolling healthcare providers with insurance companies, re-credentialing updating databases, and problem-solving enrollment issues to ensure timely and accurate network participation.

Requirements

• Associate’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

Responsibilities

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

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree