Payer Enrollment Specialist

Brightside Health delivers life-saving virtual mental healthcare to everyone who needs it. We are powered by proprietary AI, purpose-built technology, a world-class clinician network, and a care model that rivals the best of in-person treatment. When combined with precision psychiatry and leading-edge therapeutic techniques, we??e able to improve outcomes for those with mild-to-severe clinical... depression, anxiety, and other mood disorders.
We take an action-oriented, purposeful approach with everything we do and seek out team members who value collaboration and thoughtful prioritization. As a result, our organization is looking for the brightest and most innovative talent in the industry. We can promise you that, as a member of the Brightside team, you??l have the opportunity to collaborate alongside smart and driven people while growing your professional skills.
We are looking for an experienced Payer Enrollment Specialist to join our expanding credentialing team, reporting directly to the Senior Manager, Credentialing and Enrollment. In this role, you will be responsible for enrolling all clinicians in contracted health plans including Medicare and Medicaid. You will partner closely with our commercial team and external payers. Ultimately, this role will be responsible for accurately and timely enroll clinicians in health plans across the US. Continuous and persistent follow-up with payers for statuses is important all while building effective relationships with contacts.
What you??l be doing as a Payer Enrollment Specialist:
??Initiate online and paper group and individual enrollment application submissions for new and existing contracted commercial payers including Medicare and Medicaid.
??Follow-up on submitted enrollment applications to completion, escalating to leadership as needed
??Respond to internal requests for information including status updates
??Maintain a list of contacts with various payers
??Work with providers to obtain information needed to complete enrollment applications and follow up as necessary
??Maintain CAQH and PECOS profiles
??Work collaboratively across departments
??Ensure provider demographic data is kept up to date in credentialing system and with applicable payers
??Document all activity and maintain accurate records in the credentialing system
??Maintain confidentiality
??Perform other duties as assigned
Requirements
??2+ years of experience enrolling with health plans including Medicare and Medicaid programs
??Proficiency with applicable online portals including but not limited to CAQH, PECOS and Availity
??Ability to work quickly and efficiently while maintaining accuracy
??Excellent verbal, written, and social skills
??Self-starter with the ability to work independently and proactively
??Highly detail oriented
??Able to work under pressure and adapt easily to change
??Consistently create a positive work environment by being team-oriented
??Excellent time and workload management skills
??Experience with credentialing processes a plus
??Knowledge of NCQA requirements, preferred
Benefits
??A competitive compensation
??Fully paid for comprehensive health care (medical, dental, vision)
??Pet Insurance
??401k Plan
??15 days paid vacation (accrued throughout the year), 3 paid sick days, 3 paid personal days
??Paid holidays
??Work remotely. Monday - Friday, 9am - 5pm
??Additional memberships and perks
Final offer amounts are determined by multiple factors including geographic location as well as candidate experience and expertise. If you have questions on compensation bands, please ask your recruiter.
Brightside Health is committed to equal employment opportunities for all team members. Every decision we make regarding employment is solely based on merit, competence, and performance. We are committed to building a team that represents a variety of backgrounds, perspectives, and skills. We realize the full promise of diversity and want you to bring your whole self to work every single day.
Research shows that underrepresented groups typically apply only if they meet 100% of the criteria listed. At Brightside, we are dedicated to fair play and encourage women, people of color, and LGBTQ+ job seekers to apply for positions even if they don?? check every box for the role

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