Overview

PAYOR ENROLLMENT SPECIALIST Job Description Department: Payor Enrollment/CredentialingReports To: Director of Business AdministrationLocation: OnsiteEmployment Status: Full-TimeEmployment Type: HourlyLevel: Entry-level Travel Required: No Job Summary The Payor Enrollment Specialist is responsible for obtaining, maintaining, and managing provider and organizational enrollments with commercial insurance carriers, government payers, managed care organizations, and electronic clearinghouses. This position ensures timely enrollment for claims submission, electronic remittance advice (ERA), electronic funds transfer (EFT), eligibility verification, and other electronic transactions essential to reimbursement operations.The Payor Enrollment Specialist serves as the primary liaison between US Neuro, insurance carriers, clearinghouses, and internal stakeholders to ensure uninterrupted claims processing and payment workflows. The role requires strong attention to detail, effective project management, and a thorough understanding of healthcare revenue cycle operations. US Neuro Expectations Comply with all US Neuro policies, procedures, and confidentiality requirements.Consistently demonstrate US Neuro's core values through professional conduct and ethical behavior.Maintain a positive, respectful, and professional attitude in all interactions with patients, colleagues, clients, and business partners.Communicate effectively and regularly with immediate supervisors regarding responsibilities, priorities, and any workplace concerns.Report to work on time, prepared, and ready to fulfill all assigned job duties.Meet established productivity, quality, and performance standards while adapting to changing workload demands.Safeguard patient information and manage all records in strict compliance with HIPAA regulations and company policies.Ensure accurate, timely, and complete data entry, documentation, and record maintenance.Foster a collaborative work environment by working positively and effectively with team members across all departments.Demonstrate accountability, reliability, and a commitment to supporting organizational goals and delivering exceptional service. Key Responsibilities Payor Enrollment ManagementInitiate, complete, and submit enrollment applications for commercial, Medicare, Medicaid, and managed care payers.Coordinate provider, group, facility, and organizational enrollments with insurance carriers.Maintain active enrollment status with all contracted payers.Monitor enrollment application progress and follow up on pending requests.Resolve enrollment rejections, delays, and discrepancies.Ensure timely completion of revalidations, credentialing-related enrollments, and payer updates. Clearinghouse and EDI ManagementManage payer enrollments through clearinghouse platforms.Coordinate setup and maintenance of: Electronic Claims SubmissionElectronic Remittance Advice (ERA)Electronic Funds Transfer (EFT)Eligibility Verification TransactionsMonitor clearinghouse reports and identify inactive or missing payer connections.Work with payers and clearinghouse partners to troubleshoot EDI-related issues. Documentation and ComplianceCollect, maintain, and organize required enrollment documentation, including: Provider NPIsGroup NPIsTax Identification NumbersW-9 FormsBank LettersEFT DocumentationLicenses and CertificationsAuthorized SignaturesMaintain accurate records of enrollment approvals, effective dates, and payer-specific requirements.Ensure compliance with payer regulations and organizational standards. Revenue Cycle SupportPartner with Billing, Credentialing, Contracting, and Finance teams to support reimbursement operations.Identify enrollment issues impacting claims submission or payment processing.Assist in resolving payer enrollment-related claim denials.Support new provider onboarding and facility acquisitions by coordinating enrollment activities.Maintain a master inventory of all active payer enrollments and electronic transac