Senior Payer Enrollment Specialist

US Fertility•,

1d•$55,000 - $65,000•Remote

About The Position

US Fertility is hiring a Senior Payer Enrollment Specialist to join its remote team. The role supports payer enrollment and provider data management across the organization’s fertility practices, helping ensure accurate participation information, compliant documentation, and efficient enrollment workflows. The specialist will also support, train, and mentor the payer enrollment team and contribute to process improvements and departmental projects. The schedule is Monday through Friday, 7:30 AM to 4:30 PM Eastern Time. Compensation is $55,000 to $65,000 per year, commensurate with experience.

Requirements

Associate degree and three years of payer enrollment experience, or five years of experience in lieu of a degree.
CPCS certification is required within two years if the candidate is not already certified.
Knowledge of payer enrollment, provider participation, and applicable regulatory requirements.
Proficiency with Microsoft Office, CAQH ProView, NPPES, OIG, and payer portals.
Strong attention to detail, organization, and documentation skills.
Effective and professional communication with internal and external stakeholders.
Ability to maintain confidentiality when handling sensitive provider and organizational information.
Ability to research and effectively resolve payer enrollment and provider data issues.
Ability to manage multiple priorities and deadlines in a fast-paced environment.
Strong customer service, problem-solving, teamwork, and adaptability.

Nice To Haves

Bachelor’s degree preferred.
CPCS, CPES, RHIA, or RHIT certification preferred.

Responsibilities

Manage initial and recredentialing payer enrollment for groups, facilities, physicians, and advanced practice providers across insurance plans.
Coordinate the addition of new service locations and maintain accurate payer contract participation.
Manage monthly payer roster submissions and maintain enrollment workflows, policies, and procedures.
Use payer portals, including Availity, UHC, Kaiser, and LexisNexis, to manage enrollment and provider data.
Maintain accurate provider, practice, and group information across NPPES, CAQH, payer portals, and directories.
Conduct quarterly provider data attestations and validate demographic and participation information.
Audit enrollment activities and documentation for accuracy, compliance, and adherence to established processes.
Research and resolve payer enrollment issues and ensure provider information meets payer and organizational requirements.
Coordinate malpractice insurance certificates and annual Certificates of Insurance renewals.
Support, train, and mentor the payer enrollment team and contribute to departmental initiatives and special projects.
Identify and implement process improvements to enhance enrollment efficiency, accuracy, and team performance.