Payer Enrollment Job at Randstad (Hyderabad)

Provider Enrollment Specialist II - HP Enrollment Eligibility

Coordinates Medicare and Medicaid enrollment/re-enrollment and managed care cred...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High School Diploma
1-3 years of Payer Enrollment experience
Solid knowledge and utilization of PC applications to include WORD, EXCEL, ACCESS
Excellent written and verbal communication skills
Excellent organization and planning skills with demonstrated teamwork skills
Proven ability to interact with all levels of management and other Associates

Job Responsibility

Collects and maintains data on providers for Medicare and Medicaid enrollment
Prepares and submits applications to Medicare and Medicaid for new provider enrollments and existing provider updates
follows up by telephone or in writing, with carriers regarding application status
Complies with Medicare and Medicaid provider enrollment guidelines
Requests NPI numbers for providers and clinics as necessary and maintains NPI files
Follows up, either by telephone or in writing, with insurance companies and patients regarding the processing of outstanding claims and/or appeals
Generates various reports to identify outstanding claims issues with provider numbers and non-payment
Communicates information to appropriate personnel
Educates staff on corrections, e.g.. front-end entry errors in a positive, constructive manner
Collects and reviews managed care contracts for correct billing and payment terms

Fulltime

EDI Payer Enrollment Coordinator

We're partnering with a healthcare organization, to find a talented EDI Payer En...

Location

United States , Costa Mesa

Salary:

41.00 - 52.00 USD / Hour

Onward Search

Expiration Date

Until further notice

Requirements

Excellent communication and interpersonal abilities
Strong organizational and time management skills
Capable of handling a high volume of cases while meeting deadlines
Proven problem-solving and analytical skills
Prior experience with EDI payer enrollment processes and proficiency in Microsoft Office tools.

Job Responsibility

Manage and supervise payer enrollment activities to guarantee accurate, timely submissions
Work directly with payer organizations to understand enrollment requirements and ensure documentation completeness
Review enrollment materials thoroughly before submission to verify accuracy
Follow up with payers and vendors regarding the status of enrollment applications
Provide updates on enrollment statuses to clients, payers, vendors, and internal teams.

What we offer

Medical, Dental, and Vision Insurance
Life Insurance
401(k) Program
Commuter Benefit
eLearning and Ongoing Training
Education Reimbursement

Fulltime

Esi Payer Enrollment Coordinator

We're partnering with a healthcare organization, to find a talented EDI Payer En...

Location

United States , Costa Mesa

Salary:

41.00 - 52.00 USD / Hour

Onward Search

Expiration Date

Until further notice

Requirements

Excellent communication and interpersonal abilities
Strong organizational and time management skills
Capable of handling a high volume of cases while meeting deadlines
Proven problem-solving and analytical skills
Prior experience with EDI payer enrollment processes and proficiency in Microsoft Office tools.

Job Responsibility

Manage and supervise payer enrollment activities to guarantee accurate, timely submissions
Work directly with payer organizations to understand enrollment requirements and ensure documentation completeness
Review enrollment materials thoroughly before submission to verify accuracy
Follow up with payers and vendors regarding the status of enrollment applications
Provide updates on enrollment statuses to clients, payers, vendors, and internal teams.

What we offer

Medical, Dental, and Vision Insurance
Life Insurance
401(k) Program
Commuter Benefit
eLearning and Ongoing Training
Education Reimbursement

Provider Enrollment Specialist Senior

This role serves as a Payer Enrollment liaison. Represents Payer Enrollment on m...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High school diploma or equivalent required
3-5 years of Payer Enrollment experience preferred
Solid knowledge and utilization of PC applications including Microsoft Word and Excel
Excellent written and verbal communication skills
Excellent organization and planning skills with demonstrated teamwork skills
Proven ability to interact with all levels of management and other Associates
In accordance with the CHRISTUS Health License, Certification and Registration Verification Policy, all Associates are required to obtain the required certifications for their respective positions within the designated time frame.

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Collaborates with CBO and local operations on enrollment related issues
Attends and provides enrollment related updates on matrix calls
Collaborates with Credentialing Team and local operations on items needed
Updates Credentialing/Payer Enrollment database as needed
Accesses payer databases as needed to ensure appropriate enrollment
Performs multi-state Medicaid Enrollment through state portals
Submits updates as needed to payers
Maintains internal enrollment database
Educates associates on enrollment processes when needed

Fulltime

Credentialing Specialist

We are seeking a Credentialing Specialist who will be responsible for maintainin...

Location

United States

Salary:

22.00 - 27.00 USD / Hour

Expressable

Expiration Date

Until further notice

Requirements

High school diploma or equivalent required
Hands-on experience completing and submitting credentialing and enrollment applications for commercial payers, medicaid, and medicare
Experience maintaining provider files and ensuring compliance with payer and regulatory requirements
Prior experience working directly with providers to collect, validate, and update credentialing information
Familiarity with auditing provider data across multiple systems and resolving discrepancies
Experience following up with payers regarding application status, re-credentialing, and demographic updates
Exposure to denial resolution or authorization issues related to credentialing strongly preferred
Proficiency with credentialing platforms and databases
Strong working knowledge of payer credentialing and enrollment workflows
Comfortable navigating payer portals and researching payer-specific requirements

Job Responsibility

Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications
Maintain accurate provider profiles on CAQH, NPPES and any other applicable profiles
Complete credentialing applications to add current and new providers to commercial, Medicaid, and Medicare payers
Work closely with current and onboarding providers to obtain all necessary information to complete the credentialing and enrollment process
Audit provider information in various systems
Follow up with payers as it relates to credentialing, enrollment, and demographic updates
Research payer processes as it relates to credentialing, enrollment, and demographic updates
Assist in identifying and resolving any denials or authorization issues related to provider credentialing

What we offer

Exceptional paid time off policies that encourage and support life balance, including a winter break
401k matching
Health insurance options
Company paid life, short-term disability, and long-term disability coverage
Remote work environment

Fulltime

Enrollment Coordinator

Ansible Health seeks a dedicated and detail-oriented Enrollment Coordinator to j...

Location

United States

Salary:

55000.00 - 60000.00 USD / Year

AnsibleHealth Inc.

Expiration Date

Until further notice

Requirements

Experienced with such as systems PECOS, CAQH, MAC portals, and commercial payer portals
2+ years of payer enrollment and/or credentialing experience in a healthcare setting (commercial, Medicare, Medicaid)
Strong organizational and time-management skills
able to manage multiple priorities under deadlines
High attention to detail and accuracy in handling provider data and applications
Strong communication skills, with the ability to liaise across internal teams and with payer representatives
Comfortable working independently in a remote, contract environment

Job Responsibility

Manage payer enrollment applications across commercial, Medicare, and Medicaid plans, ensuring accurate and timely submissions
Maintain payer portals (e.g., United, Medicare MACs, Medicaid state systems, commercial payer portals), including updates to tax IDs, provider demographic information, and group contracts
Track and reconcile enrollment statuses across internal tracking sheets and payor portals to ensure data accuracy and workload transparency
Monitor and follow up on applications through payer portals and escalate issues when timelines stall
Ensure revalidations, updates, and corrections are submitted promptly to prevent billing disruptions
Collaborate with internal stakeholders (credentialing, revenue cycle, and operations teams) to resolve enrollment-related issues and communicate changes (e.g., contract or tax ID updates)
Provide recommendations on process improvements to reduce delays and improve payer communication
Work within Athena payer enrollment processes, updating and maintaining provider records to reflect current contracts, tax IDs, and group associations

Fulltime

Credentialing Specialist

We are seeking a Credentialing Specialist for a short term contract in Nashville...

Location

United States , Nashville

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma or equivalent (Associate’s or Bachelor’s degree in Healthcare Administration or related field preferred)
1–3 years of experience in healthcare credentialing, provider enrollment, or medical staff services
Knowledge of payer enrollment processes (Medicare, Medicaid, commercial payers)
Familiarity with credentialing standards and regulatory requirements
Proficiency with credentialing software, provider databases, and Microsoft Office (Excel, Word, Outlook)
Strong organizational skills with high attention to detail
Excellent written and verbal communication skills

Job Responsibility

Coordinate and process initial credentialing, recredentialing, and payer enrollment for healthcare providers
Collect, verify, and maintain provider documentation including licenses, certifications, education, training, work history, NPIs, and DEA registrations
Prepare and submit credentialing and enrollment applications to insurance payers, hospitals, and regulatory bodies
Monitor credential expirations and proactively manage renewals to maintain continuous provider eligibility
Maintain accurate and up‑to‑date credentialing records in credentialing software and internal databases
Serve as a liaison between providers, payers, medical staff offices, and internal departments
Track application statuses, follow up on outstanding items, and resolve credentialing or enrollment issues
Ensure compliance with CMS, NCQA, Joint Commission, state, and payer credentialing requirements
Support audits and accreditation reviews by preparing and providing credentialing documentation
Maintain strict confidentiality of sensitive provider information

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Medical Credentialing Specialist

The Robert Half Healthcare Practice is working with a healthcare network to brin...

Location

United States , Indianapolis

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Must have Payer enrollment experience
Must have Primary Source Verification (PSV) experience
Must know how to use the following Credentialing software, PECOS, Medicare and Medicaid Enrollments for both provider and Facility, MPPES, CAQH and Excel
Knowledge of working with National Payors (UHC, Anthem BCBS, Etc)
Must know how to manage reports
Must have knowledge of working claims and denials
Bachelors and a CPCS preferred

Job Responsibility

Provider Credentialing: Review provider credentials, maintain accurate electronic data, and complete ARMS credentialing and re-credentialing
Payer Enrollment: Complete, monitor, and follow up on provider credentialing and payer enrollment with all commercial, Medicaid, Medicare, and Medicaid managed care payers
Data Management: Maintain CAQH, NPPES/PECOS, and state license information for all providers
Risk Management: Obtain and maintain malpractice coverage, EMR licenses, and signed physician contracts
Compliance: Ensure compliance with the affiliate, state, and federal regulations
Equity and Accountability: Demonstrate commitment to health equity, racial equity, and continuous improvement

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan
free online training

Fulltime

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