Payer Relations Specialist

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-credentialinghttps://www.google.com/search?q=re-credentialing&rlz=1C1UEAD_enUS1140US1140&oq=Payer+relations+credentialing+associate+job+description&gs_lcrp=EgZjaHJvbWUyBggAEEUYOTIHCAEQIRigATIHCAIQIRigATIHCAMQIRigAdIBCjE4NTM2ajBqMTWoAgiwAgHxBau9jmYL0o_e&sourceid=chrome&ie=UTF-8&mstk=AUtExfBv5LwyNM0gip-tHhAAqXq925OPvbKRpLh-ai_lJ91uhGGEeYsqWxw8l265Z0V8fG9gLhkikVz69k2Y8AWmJ-earksaNwC70P11_VXR6onwBNYnN7Y7ANe7DvhQZwZDn8Q&csui=3&ved=2ahUKEwiakMK24Z-SAxUiCnkGHbufB2oQgK4QegQIARAD, 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.