PAYER ENROLLMENT SPECIALIST

A/R Services
FT/ Days/ 80 hours per pay

General Summary/Responsibilities:
Responsible for managing the credentialing and payer enrollment process for providers, offices, and groups by 
completing third party insurance applications and contracts. Develops and maintains physician and group profiles 
and data bases. Preparation and submission of all third-party provider applications and contracts. The position will 
function as a resource and primary contact for payer enrollment related questions and issues between offices, and 
third-party insurance companies. Responsible for monitoring and follow up of credentialing claim holds and denials.

Qualifications

Education
Minimum Level of Education Required: High School completion / GED
Additional requirements:
▪ Type of degree: N/A
▪ Area of study or major: N/A
▪ Preferred educational qualifications: Business or Computers with experience in health care 
billing, reimbursement, and/or contracting
▪ Position specific testing requirement: N/A
Licensure/Certification/Registration
▪ List any Licensure/Certification/Registration required by the position. Please see Lawson Code 
Reference Sheet.

Experience
Minimum Level of Experience Required: 1 - 3 years of job-related experience
Prior job title or occupational experience: A minimum of one year experience in Credentialing/Payer 
Enrollment
Prior specific functional responsibilities: Qualified candidates will have knowledge of, and some 
experience with third party credentialing process.
Preferred experience: 3+ years’ experience with medical billing is preferred
Other experience requirements: Proficiency in Microsoft Word and Excel. Cactus or similar Database

Knowledge/Skills

▪ Demonstrated proficiency in Microsoft Word, database management and basic computer 
knowledge. Knowledge of medical terminology. Possess good communication skills (writing and 
verbal), diplomacy, tact, attention to detail and problem-solving skills. Must be able to work with all 
levels of the organization which includes practitioners, administration and hospital staff. 
Coordinate, organize, prioritize, and handle multiple projects with many disruptions. Highly 
motivated and able to work independently in a high-volume department. Willingness to adapt to 
flexible work schedules. Loyal, reliable, tactful, honest and discreet, maintaining confidentiality at 
all times. Exhibit professional appearance and demeanor.