Payer Enrollment Specialist

Guidehouse

. Complete and manage payer applications for initial enrollment and re-enrollment .

Posted 10/26/2026full-timeRemote • United StatesJunior💰 $35,000 - $58,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in payer enrollment processes, compliance with regulatory requirements, and effective management of provider information using MD-Staff or similar software. Strong ability to coordinate with insurance payers and resolve enrollment-related issues while maintaining accurate records.

Highest-signal resume keywords

Payer Enrollment ManagementMD-Staff Software ProficiencyCompliance with Regulatory RequirementsDelegated Roster ManagementProvider Information Maintenance

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Payer Applications ManagementProvider Enrollment Records MaintenanceEnrollment ReportingIssue ResolutionData Entry and Maintenance

Soft Skills

CollaborationCommunicationProblem-Solving

Tools & Technologies

MD-Staff SoftwareTracking Spreadsheets

Industry Keywords

Healthcare OperationsInsurance PayersProvider CredentialingRegulatory Compliance

About the role

Key responsibilities & impact

Complete and manage payer applications for initial enrollment and re-enrollment
Ensure compliance with organizational standards and regulatory requirements
Coordinate with insurance payers to maintain accurate provider enrollment records for government and commercial payers
Develop and distribute monthly delegated provider rosters
Collaborate with the medical credentialing team on provider enrollments and terminations
Serve as a point of contact for payer enrollment inquiries and issues
Identify and resolve enrollment-related issues with insurance payers
Enter, maintain, and update provider information in payer enrollment systems
Use MD-Staff or similar software to track application statuses and follow up on pending requests
Update tracking spreadsheets and provide enrollment reports to leadership and stakeholders
Ensure active providers are enrolled with relevant payers
Submit timely updates for provider terminations and other changes
Generate reports on enrollment progress, compliance, and delegated roster updates
Recommend process improvements and complete assigned duties supporting payer enrollment operations

Requirements

What you’ll need

High School Diploma / GED or 3 years of relevant equivalent experience in lieu of Diploma / GED
1-3+ year's experience in office, business, operations, customer service or healthcare field
Operational experience with MD-Staff or other payer enrollment software
Experience with delegated roster management for insurance payers

Benefits

Comp & perks

Medical, Rx, Dental & Vision Insurance
Personal and Family Sick Time & Company Paid Holidays
Position may be eligible for a discretionary variable incentive bonus
Parental Leave
401(k) Retirement Plan
Basic Life & Supplemental Life
Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
Short-Term & Long-Term Disability
Tuition Reimbursement, Personal Development & Learning Opportunities
Skills Development & Certifications
Employee Referral Program
Corporate Sponsored Events & Community Outreach
Emergency Back-Up Childcare Program
Flexible benefits package