Senior Payer Enrollment Specialist

Shady Grove Fertility

. Manage initial and recredentialing payer enrollment for groups, facilities, physicians, and APPs across insurance plans .

Posted 11/9/2026full-timeRemote • United StatesSenior💰 $55,000 - $65,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in payer enrollment management, including proficiency in utilizing payer portals and maintaining compliance with regulatory requirements. Strong organizational and communication skills are essential for managing provider data and enhancing enrollment processes.

Highest-signal resume keywords

Payer Enrollment ManagementCPCS CertificationMicrosoft Office ProficiencyProvider Participation KnowledgeAttention To Detail

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Payer EnrollmentProvider Data ManagementEnrollment Workflow CoordinationAudit ComplianceProcess Improvement

Soft Skills

Effective CommunicationProblem-SolvingTeamworkAdaptabilityCustomer Service

Tools & Technologies

AvailityUHCKaiserLexisNexisCAQH ProViewNPPESOIG

Certifications & Qualifications

CPCSCPESRHIARHIT

Industry Keywords

Payer Contract ParticipationProvider Information AccuracyDemographic ValidationEnrollment PoliciesMalpractice Insurance Coordination

About the role

Key responsibilities & impact

Manage initial and recredentialing payer enrollment for groups, facilities, physicians, and APPs across insurance plans
Coordinate the addition of new service locations and maintain accurate payer contract participation
Manage monthly payer roster submissions and maintain efficient enrollment workflows, policies, and procedures
Utilize payer portals, including Availity, UHC, Kaiser, and LexisNexis, to manage enrollment and provider data
Maintain accurate provider, practice, and group information across NPPES, CAQH, payer portals, and directories
Conduct quarterly provider data attestations and validate demographic and participation information
Audit enrollment activities and documentation for accuracy, compliance, and adherence to established processes
Research and resolve payer enrollment issues while ensuring provider information meets payer and organizational requirements
Coordinate malpractice insurance certificates and annual Certificates of Insurance renewals
Support, train, and mentor the payer enrollment team while contributing to departmental initiatives and special projects
Identify and implement process improvements that enhance enrollment efficiency, accuracy, and overall team performance

Requirements

What you’ll need

An associate degree and three years of payer enrollment experience, or five years of experience in lieu of a degree
Bachelor’s degree preferred
Prefer CPCS, CPES, RHIA, or RHIT certification; CPCS required within two years if not already certified
Knowledge of payer enrollment, provider participation, and applicable regulatory requirements
Proficiency with Microsoft Office, CAQH ProView, NPPES, OIG, and payer portals
Strong attention to detail, organization, and documentation skills
Effective and professional communication with internal and external stakeholders
Ability to maintain confidentiality when handling sensitive provider and organizational information
Ability to research and resolve payer enrollment and provider data issues effectively
Ability to manage multiple priorities and deadlines in a fast-paced environment
Strong customer service, problem-solving, teamwork, and adaptability

Benefits

Comp & perks

Medical, dental, and vision insurance
401(k) with company match
Tuition assistance and professional development support
Performance-based bonus opportunities
Generous paid time off, paid holidays, and paid parental leave
Life and disability benefits
Fertility Discount Program
Employee wellness and recognition programs