Specialist, Payer Enrollment

58 minutes ago
Full-time
Mid Level
Operations
Medallion

Medallion

Medallion is a healthcare operations platform that automates credentialing, enrollment, and licensing processes, saving time and increasing revenue for healthcare companies.

Health Care Providers & Services
51-250
$85M raised

Description

  • Oversee the end-to-end health plan enrollment process from application retrieval to client notification in coordination with external vendor partners.
  • Directly complete highly escalated enrollment requests when needed.
  • Monitor in-process enrollments through consistent follow-up by telephone, email, and portal, and maintain thorough documentation in Medallion systems.
  • Maintain working knowledge of payer-specific enrollment requirements, supporting documentation, completion standards, and applicable regulations.
  • Ensure provider profiles contain accurate and complete supporting documentation, including onboarding documents, application copies, and welcome letters.
  • Prepare client updates to communicate enrollment status and progress.
  • Build and maintain relationships with payer representatives and contracting departments to improve submission efficiency and approval timelines.
  • Support revalidation processes to keep providers active in health plans.
  • Track enrollment timelines and deadlines to ensure compliance with submission requirements.
  • Investigate and resolve enrollment delays, rejections, and discrepancies by coordinating with providers, payers, and vendor partners.

Requirements

  • At least 3+ years of direct experience with payer enrollment-related applications and processes.
  • Familiarity with health plan enrollment workflows and related requirements.
  • Experience using GSuite tools, including GSheets, GDocs, and GMail.
  • Strong attention to detail and ability to ensure complex enrollment packages are complete and correct.
  • Strong communication skills with internal and external stakeholders at all levels.
  • Ability to work collaboratively in a team-oriented environment and build productive working relationships.
  • Ability to stay current with payer policies, state and federal regulations, and industry best practices relevant to enrollment processes.

Benefits

  • Compensation of $20/hr to $28/hr depending on location and level.
  • Opportunity to work at a fast-growing healthcare technology company.
  • Mission-driven work focused on improving provider operations and healthcare workflows.
  • Candidate safety guidance with official communication sent only from @medallion.co email addresses.

Interested in this position?

Apply directly on the company website

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