Privia Health is hiring a Payer & Provider Enrollment Specialist

Privia Health is hiring a Payer & Provider Enrollment Specialist to serve as the primary contact for our Enrollment Department and manage the complete payer enrollment process for our independent providers.

What You'll Do

• Enroll new providers with all commercial health plans specific to their market.
• Enroll new providers with both Medicaid and Medicare.
• Manage enrollment data in CredentialStream, entering key dates for submissions and effective status.
• Review provider record data, such as taxonomy and specialty, for accuracy prior to application submission.
• Perform follow-ups with health plans 30 days after submission and biweekly until the provider is PAR.
• Escalate known issues to your manager for assistance.
• Collaborate regularly with the credentialing team to coordinate new provider onboarding.
• Attend RCM and payer calls, as well as other internal stakeholder meetings as needed.

What We're Looking For

• 2+ years of experience in a payer enrollment function.
• Experience with RCM and enrollment claim resolution.
• Required experience with Medicare and Medicaid payers.
• Demonstrated skills in problem solving, analysis, and resolution.
• Ability to function independently and manage multiple projects with flexibility.
• Must comply with all HIPAA rules and regulations.
• Ability to communicate appropriately and effectively with providers, including sensitive and confidential information.
• A high level of attention to detail and exceptional organizational skills.
• Ability to exercise independent judgment.
• Skill in problem solving, exploring all options, and using available resources to find effective solutions.

Nice to Have

• Experience with both Delegated and Non-Delegated payer enrollment.
• Experience with Verity CredentialStream or other credentialing software.

Technical Stack

• CredentialStream

Benefits & Compensation

• Compensation range: $50,000.00-$55,000.00
• Medical, dental, vision, life, and pet insurance.
• 401k plan.
• Paid time off.
• Other wellness programs.

Work Mode

This position is remote.

Privia Health is committed to creating a work environment where you can bring your whole self to work. We encourage all qualified individuals to apply, regardless of age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by law. All information will be kept confidential according to EEO guidelines.