System Payor Enrollment Specialist (Full-time; Days) - LCMC Health Corporate
About The Position
The System Payor Enrollment Specialist coordinates provider enrollment, credentialing, and re-credentialing with Medicare, Medicaid, and commercial insurance payors. The role tracks applications, approvals, revalidations, and deadlines; works with providers to obtain information and complete documentation; and communicates with payors to resolve enrollment issues and follow up on pending applications. The specialist maintains provider records, electronic files, CAQH profiles, directories, and enrollment information. In partnership with billing, coding, medical staff, and other teams, the role helps prevent enrollment-related billing delays, monitors enrollment status, identifies outstanding issues, and prepares reports for leadership. The position also stays current on payor requirements, healthcare regulations, and NCQA standards and helps improve enrollment workflows. This work supports provider readiness to deliver care and accurate claim processing.
Requirements
- High school diploma or GED (or equivalent), or 2+ years of experience in administrative support, insurance enrollment, payor credentialing, billing, or a related field.
- Strong organizational skills and exceptional attention to detail.
- Excellent written and verbal communication skills.
- Confidence using Microsoft Office, including Excel, Outlook, Word, and PowerPoint.
- Ability to maintain accurate records, databases, and documentation.
- Strong follow-up skills and the ability to manage multiple deadlines.
- Critical thinking and problem-solving abilities.
- Ability to work independently while maintaining confidentiality.
- Willingness to learn and navigate healthcare insurance enrollment requirements.
Responsibilities
- Coordinate provider enrollment, credentialing, and re-credentialing with Medicare, Medicaid, and commercial insurance payors.
- Track applications, approvals, revalidations, and deadlines to keep enrollment processes on schedule.
- Work with providers to gather accurate information and complete required documentation.
- Communicate with insurance payors to resolve enrollment issues, verify participation dates, and follow up on pending applications.
- Maintain accurate provider records, electronic files, and CAQH profiles.
- Partner with billing, coding, medical staff, and other teams to help prevent enrollment-related billing delays.
- Monitor enrollment statuses, identify outstanding issues, and prepare reports for leadership.
- Keep provider directories and enrollment information accurate and up to date.
- Stay informed about changing payor requirements, healthcare regulations, and NCQA standards.
- Identify opportunities to improve processes and make enrollment workflows more efficient.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
