06 Aug
|
Informica Solutions
|
Pune
06 Aug
Informica Solutions
Pune
Job Summary
The Payor Enrollment Specialist will be responsible for managing the end-to-end provider enrollment
process with commercial insurance payors, Medicare, Medicaid, and other government health plans.
The ideal candidate will ensure timely and accurate submission of enrollment applications, maintain
provider records, and collaborate with internal teams to support successful provider onboarding and
uninterrupted reimbursement.
Key Responsibilities
- Complete and submit provider enrollment, revalidation, and re-enrollment applications with
commercial and government payors.
- Manage provider enrollment through various payer portals and applications.
- Maintain and update provider information in CAQH and other enrollment databases.
- Track enrollment applications and follow up with insurance companies to ensure timely
processing.
- Coordinate with credentialing, licensing, and operations teams to obtain required
documentation.
- Resolve enrollment-related issues by communicating with payors and internal stakeholders.
- Maintain accurate records of application status, approvals, expirations, and renewals.
- Ensure compliance with payer guidelines, regulatory requirements, and organizational
policies.
- Prepare enrollment status reports and maintain proper documentation.
- Assist with provider onboarding and offboarding activities related to payor enrollment.
Required Qualifications
- Bachelor's degree in any discipline.
- 1–3 years of experience in US Healthcare Payor Enrollment, Provider Enrollment,
Credentialing, or a related healthcare operations role.
- Strong understanding of Medicare, Medicaid, and commercial payor enrollment processes.
- Experience working with CAQH, NPPES, PECOS, and insurance payer portals is preferred.
- Excellent written and verbal communication skills.
- Strong attention to detail and organizational skills.
- Ability to manage multiple tasks and meet deadlines in a fast-paced workplace.
- Proficiency in Microsoft Excel, Word, and Outlook.
Preferred Skills
- Knowledge of provider credentialing and licensing processes.
- Experience with healthcare practice management or credentialing software.
- Solid analytical and problem-solving abilities.
- Ability to work independently while collaborating effectively with cross-functional teams.
- Familiarity with HIPAA compliance and healthcare regulations.
What We Offer
- Opportunity to work with a fast-growing US healthcare organization.
- Professional growth and learning opportunities.
- Collaborative and supportive work environment.
- Competitive compensation and performance-based growth.
📌 Payor Enrollment Specialist - Pune (1+ Years)
🏢 Informica Solutions
📍 Pune