Payer Enrollment Specialist

Job Title: Payer Relations Specialist

Reports to: Payer Relations Manager

Employment: Full-Time, Hourly 

Location: Maplewood, NJ; Remote Position

Company Summary:

StationMD is a telehealth company dedicated to serving individuals with intellectual and/or developmental disabilities (I/DD). All StationMD clinicians are board-certified and specially trained to treat individuals with I/DD. Clinicians are available 24/7 via telemedicine for urgent and non-urgent medical matters. StationMD also offers scheduled psychiatry visits via telemedicine to individuals with I/DD. In providing this suite of services, StationMD enables individuals with I/DD faster access to high-quality care and substantially reduces unnecessary medical costs.

Position Summary:

We are seeking a Payer Enrollment Specialist 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.  

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 portals 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

Qualifications:

• 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 

StationMD is an equal opportunity employer.