Job Title: Payer Relations Specialist
Reports to: Payer Relations Manager
Employment: Full-Time, Hourly
Location: Maplewood, NJ; Remote Position
Company Summary:
StationMD is a telehealth company dedicated to serving individuals with intellectual and/or developmental disabilities (I/DD). All StationMD clinicians are board-certified and specially trained to treat individuals with I/DD. Clinicians are available 24/7 via telemedicine for urgent and non-urgent medical matters. StationMD also offers scheduled psychiatry visits via telemedicine to individuals with I/DD. In providing this suite of services, StationMD enables individuals with I/DD faster access to high-quality care and substantially reduces unnecessary medical costs.
Position Summary:
We are seeking a Payer Relations Credentialing Associate to assist with the process of enrolling healthcare providers with insurance companies, re-credentialing, updating databases, and problem-solving enrollment issues to ensure timely and accurate network participation.
Responsibilities:
- Application Management: Prepare and submit initial and renewal credentialing/enrollment applications for providers (physicians, facilities, etc.) with commercial and government payers
- Follow-Up: Proactively track and follow up on application statuses, ensuring timely processing and resolving delays
- Data Management: Maintain accurate provider data within internal and external portals and databases for contracted and non-contracted payers
- Liaison: Serve as a contact for providers, internal teams, and insurance companies regarding credentialing and enrollment
- Compliance: Ensure adherence to payer requirements, policies, and regulatory standards
- Issue Resolution: Troubleshoot contracting processing issues by collaborating cross functionally to develop solutions
- Monitoring: Track provider licenses, certifications, and insurance expirations
Qualifications:
- Associate’s degree or equivalent experience in healthcare or business administration
- Minimum of 4 years of credentialing and payer enrollment experience
- Strong understanding of health insurance payors and reimbursement processes
- Experience with credentialing/payor enrollment tracking software (Medallion or similar system)
- Excellent written and verbal communication skills
- Strong organizational and follow-up skills
- Ability to analyze data and identify trends
- Excellent attention to detail and accuracy
- Energy and passion for increasing access to quality healthcare and improving the quality of life for individuals with Intellectual and Developmental Disabilities
StationMD is an equal opportunity employer.
Associate's degree or equivalent experience; 4+ years credentialing and payer enrollment experience; knowledge of health insurance payors and reimbursement; experience with Medallion or similar tracking software; strong communication and organizational skills.
Key Responsibilities
- submitting applications
- tracking applications
- maintaining data
Skills & Tools
Medallion
Job Details
- Category: Business Operations
- Seniority: Mid Level
- Commitment: Full Time
- Workplace: Remote — Maplewood, New Jersey, United States
- Salary: USD 41,600 – 52,000 / year
- Languages: English
About StationMD
A telehealth company serving individuals with intellectual and developmental disabilities by providing 24/7 clinician access via telemedicine. — Industry: Healthcare