Enrollments Specialist

About the role

This role specializes in payer enrollment operations for AP Health's facility-based model. The position oversees and executes end-to-end provider enrollment processes with in-network payers.

Responsibilities

• Oversee and execute end-to-end provider enrollment processes with in-network payers while maintaining an active roster
• Work with the broader Revenue Cycle Management team to troubleshoot and work through denials as needed
• Connect with providers and payers to efficiently complete the enrollment process upon provider hire and maintain throughout their employment
• Navigate payer portals like Availity, Optum, and others to submit enrollment applications, track statuses, and resolve enrollment delays
• Collaborate with our People Operations team during the provider onboarding process to gather information and begin timely enrollments
• Manage providers CAQH profiles through employee lifecycle
• Assist in establishing Revenue Cycle SOPs and data workflows, providing feedback on enhancements for internal software and external leveraged resources

Requirements

• 2+ years of experience in healthcare revenue cycle with 2+ years managing payer enrollments (Medicare, Medicaid, and Commercial)
• Knowledge of payer enrollment processes and reimbursement rules
• Familiarity with portals like Availity and Optum
• Comply with HIPAA regulations and other healthcare standards
• Excellent communication and collaboration skills with a problem-solving approach

Qualifications

• Associate’s or Bachelor’s in healthcare administration, business, or related field (equivalent experience also accepted)
• PREFERRED: Preferred certifications in PECOS/CAQH training

Skills

• Strong organizational and time management skills
• Ability to work independently and as part of a team
• Proficiency in Microsoft Office Suite

Benefits

• Comprehensive and flexible medical, dental, and vision insurance
• Short and long-term disability, basic and supplemental life
• 401K retirement plan with company matching
• Participation in the company’s Employee Stock Option Plan (ESOP)
• Paid state license, malpractice, and other agreed upon licenses and dues
• Tuition reimbursement
• Annual $1,500 allotment accompanied by 3 paid days off for Continuing Medical Education (CME)
• Generous PTO and "life/work" balance

Pay

TBD

Schedule

Hybrid role