Payor Enrollment Specialist (SC Remote)

Ob Hospitalist Group•,

1d•$22 - $25•Remote

About The Position

The Payor Enrollment Specialist is responsible for processing provider enrollment, credentialing, and re-credentialing applications while maintaining accurate provider records and managing relationships with insurance payors, healthcare facilities, and internal stakeholders. This role requires excellent attention to detail, strong follow-through, and the ability to manage multiple priorities while meeting established turnaround times and quality standards.

Requirements

High School Diploma or equivalent required.
1+ years of payor enrollment experience, specifically with Medicaid and Managed Care payors.
Strong organizational skills with exceptional attention to detail.
Excellent verbal communication and professional telephone etiquette.
Proficiency with Microsoft Office applications, including Word and Excel.
Ability to manage multiple priorities while maintaining accuracy and meeting deadlines.
Ability to work independently in a remote environment.
Customer-service mindset when interacting with providers and payors.
Commitment to confidentiality, compliance, and quality outcomes.

Nice To Haves

Some college coursework or equivalent professional experience.
Understanding of medical terminology.
CPCS (Certified Provider Credentialing Specialist) certification.
Experience maintaining provider credentialing databases and CAQH profiles.
Experience working in healthcare credentialing, enrollment, or revenue cycle operations.

Responsibilities

Prepare, submit, and track provider enrollment applications for Medicaid, Managed Care, and other insurance payors.
Process credentialing and re-credentialing applications for healthcare providers.
Manage payer-specific enrollment requirements across multiple facilities and contracts.
Monitor credentialing and enrollment application statuses and follow up as needed.
Maintain provider credentialing records and databases.
Update and manage provider CAQH profiles, licensure information, board certifications, and insurance documentation.
Ensure provider rosters remain accurate and current.
Maintain CRM records, mail logs, and utility logs.
Build and maintain professional relationships with providers, payors, hospitals, and credentialing contacts.
Respond promptly to credentialing and enrollment requests.
Coordinate signature requests and ensure timely completion of required documentation.
Escalate unresolved provider documentation issues when necessary.
Ensure all Protected Health Information (PHI) is handled securely and in compliance with company standards.
Support compliance initiatives by communicating credentialing issues and status updates appropriately.
Meet established accuracy and turnaround-time expectations.
Participate in credentialing committee activities as needed.

Benefits

Monthly Bonus Eligibility
Benefit Eligible
Paid time off & holidays
Medical, dental, and vision insurance
Health Savings Account (with employer contribution) or Flexible Spending Account options
Paid Parental Leave
Employer Paid Basic Life and AD&D Insurance
Employer Paid Short- and Long-Term Disability
Optional Short Term Disability Buy-up plan
401(k) Savings Plan, with ROTH option
Legal Plan
Identity Theft Services
Mental health support and resources
Employee Referral program