Ob Hospitalist Group Corporate

Role Description The Payor Enrollment Specialist is responsible for processing provider enrollment, credentialing, and re-credentialing applications while maintaining accurate provider records and managing relationships with insurance payors, healthcare facilities, and internal stakeholders. This role requires excellent attention to detail, strong follow-through, and the ability to manage multiple priorities while meeting established turnaround times and quality standards. Key Responsibilities - Provider Enrollment & Credentialing - Prepare, submit, and track provider enrollment applications for Medicaid, Managed Care, and other insurance payors. - Process credentialing and re-credentialing applications for healthcare providers. - Manage payer-specific enrollment requirements across multiple facilities and contracts. - Monitor credentialing and enrollment application statuses and follow up as needed. - Provider Data Management - Maintain provider credentialing records and databases. - Update and manage provider CAQH profiles, licensure information, board certifications, and insurance documentation. - Ensure provider rosters remain accurate and current. - Maintain CRM records, mail logs, and utility logs. - Stakeholder Communication - Build and maintain professional relationships with providers, payors, hospitals, and credentialing contacts. - Respond promptly to credentialing and enrollment requests. - Coordinate signature requests and ensure timely completion of required documentation. - Escalate unresolved provider documentation issues when necessary. - Compliance & Quality - Ensure all Protected Health Information (PHI) is handled securely and in compliance with company standards. - Support compliance initiatives by communicating credentialing issues and status updates appropriately. - Meet established accuracy and turnaround-time expectations. - Participate in credentialing committee activities as needed. Qualifications - High School Diploma or equivalent required. - 1+ years of payor enrollment experience, specifically with Medicaid and Managed Care payors. - Strong organizational skills with exceptional attention to detail. - Excellent verbal communication and professional telephone etiquette. - Proficiency with Microsoft Office applications, including Word and Excel. - Ability to manage multiple priorities while maintaining accuracy and meeting deadlines. Requirements - Some college coursework or equivalent professional experience. - Understanding of medical terminology. - CPCS (Certified Provider Credentialing Specialist) certification. - Experience maintaining provider credentialing databases and CAQH profiles. - Experience working in healthcare credentialing, enrollment, or revenue cycle operations. Benefits - A mission-based company with an amazing company culture. - Paid time off & holidays so you can spend time with the people you love. - Medical, dental, and vision insurance for you and your loved ones. - Health Savings Account (with employer contribution) or Flexible Spending Account options. - Paid Parental Leave. - Employer Paid Basic Life and AD&D Insurance. - Employer Paid Short- and Long-Term Disability. - Optional Short Term Disability Buy-up plan. - 401(k) Savings Plan, with ROTH option. - Legal Plan. - Identity Theft Services. - Mental health support and resources. - Employee Referral program – join our team, bring your friends, and get paid.