Senior Associate, Credentialing and Payer Enrollment

athenahealth • Boston, MA

2d • $66,000 - $112,000

About The Position

Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all. We’re launching a new Credentialing & Payer Enrollment service and seeking a Senior Associate to be the knowledge engine for payer research and process documentation. This hands-on, detail-oriented role owns discovery and maintenance of payer enrollment requirements, payer policies, and EDI specifications—using web-based and AI-assisted research tools to build the knowledge base that enables accurate, timely enrollments and smooth customer onboarding. About the Role / Team You’ll partner closely with the Senior Manager and frontline teams to translate complex payer rules into granular, actionable processes that drive enrollment and billing success. Your work directly impacts time-to-enrollment and reduces rework and escalations by ensuring documentation is accurate, current, and easily consumable by operational teams.

Requirements

• 2–4 years experience in payer enrollment, credentialing, EDI, claims processing, or closely related domain.
• Strong familiarity with payer policies, enrollment requirements, and EDI specifications.
• Excellent research skills; comfortable navigating payer portals, vendor sites, regulatory sources, and AI research tools to synthesize complex info.
• Exceptional technical writing and documentation skills—able to create granular, actionable process instructions.
• Highly detail‑oriented, organized, and able to manage multiple research streams concurrently.
• Strong analytical skills and experience with reporting/visualization tools (Excel, Visio, Sigma, or similar).
• Comfortable working independently in a startup-phase environment with evolving processes.
• Bachelor’s degree in healthcare administration, business, or related field — or equivalent experience.

Nice To Haves

• Familiarity with Lean/Six Sigma or other process improvement methodologies is a plus.
• Knowledge of the athenahealth ecosystem is helpful.

Responsibilities

• Payer research (≈50%): discover and validate payer enrollment requirements, policies, and EDI specifications across a growing payer landscape. Use web and AI-assisted research tools to find, synthesize, and verify payer information; resolve conflicts by locating authoritative sources.
• Unscoped payer onboarding: research new payers as customers sign on and expand coverage for new markets.
• Process design & documentation (≈40%): translate research into clear, step‑by‑step process instructions, workflows, and knowledge‑base entries frontline teams can follow. Maintain and update a centralized knowledge base of payer requirements, enrollment workflows, and operational documentation in real time. Analyze processes to identify gaps and inefficiencies; use data to recommend and drive continuous improvements.
• Reporting & communication: prepare concise findings, recommendations, and updates for operations and stakeholders.
• Continuous improvement & collaboration (≈10%): share learnings across the team, pursue professional development in payer/credentialing topics, and support margin/efficiency initiatives led by the Senior Manager.

Benefits

• Along with health and financial benefits, athenistas enjoy perks specific to each location, including commuter support, employee assistance programs, tuition assistance, employee resource groups, and collaborative workspaces — some offices even welcome dogs.
• We also encourage a better work-life balance for athenistas with our flexibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level