Payer Relations Specialist

Ovation Healthcare

. Manage the end-to-end provider enrollment process, including initial enrollment, recredentialing, revalidation, and payer contracting readiness .

Posted 9/24/2026full-timeRemote • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing the provider enrollment process, including compliance with payer requirements and maintaining accurate provider records. Proficient in client communication and problem-solving to ensure timely enrollment and billing processes.

Highest-signal resume keywords

Provider Enrollment ManagementPayer Enrollment KnowledgeCredentialing Systems ProficiencyAttention to DetailExcellent Communication Skills

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

Provider EnrollmentBilling ProcessesCredentialingPayer ContractingData Management

Soft Skills

Problem-SolvingOrganizationCustomer ServiceFollow-UpTime Management

Tools & Technologies

Microsoft Office SuiteCAQHPECOSAvailityCredentialing Databases

Industry Keywords

MedicareMedicaidHealthcare AdministrationEnrollment RequirementsCompliance Standards

About the role

Key responsibilities & impact

Manage the end-to-end provider enrollment process, including initial enrollment, recredentialing, revalidation, and payer contracting readiness
Serve as a subject matter expert resource to clients on enrollment requirements, billing processes, payer setup, best practices, and compliance standards
Prepare, complete, and submit enrollment applications for individual providers and healthcare facilities across commercial and government payers, including Medicare, Medicaid, and private insurers
Maintain accurate and current provider records, including CAQH profiles, NPI registration, state license verifications, payer portal records, and other required documentation
Track enrollment status, renewal deadlines, expirations, recredentialing, and revalidation requirements; proactively follow up with payers to support timely processing and approvals
Communicate directly with clients, providers, payers, and internal teams to gather required documentation, resolve enrollment-related issues, and escalate barriers when appropriate
Update, audit, and maintain provider participation status and demographic data within internal systems and credentialing databases
Ensure payer setup and billing configuration meet contractual and regulatory requirements; advise clients on billing structure and enrollment implications
Stay current with changes in payer requirements, healthcare regulations, and credentialing standards; apply this knowledge to client recommendations and internal processes
Prepare and deliver regular status updates, dashboards, and reports to clients and internal leadership
Lead or assist with enrollment audits and support implementation of corrective action plans as needed

Requirements

What you’ll need

Associate or Bachelor’s degree in healthcare administration, business, or a related field preferred
Minimum of 3 years of experience in provider enrollment, payer enrollment, billing, credentialing, or a client-facing healthcare services role
Proficiency in Microsoft Office Suite and credentialing/enrollment systems or payer portals, such as CAQH, PECOS, Availity, and related tools
Working knowledge of commercial and government insurance payers, including Medicare and Medicaid enrollment requirements
Strong attention to detail and ability to maintain accurate provider data, documentation, and enrollment records
Excellent written and verbal communication, organization, follow-up, problem-solving, and customer service skills
Ability to manage multiple priorities, meet deadlines, and work independently in a remote environment

Benefits

Comp & perks

Remote work arrangement
Collegial atmosphere of professionalism and teamwork
Opportunity to collaborate with highly skilled subject matter specialists and operations executives