Payer Enrollment Coordinator

Job Title: Payer Enrollment Coordinator
Job Location: Cumberland, RI 02864
Job Duration 10 Months (possibility of extension)
Shift: Mon - Fri, 7:30am - 4:00pm
Payrate: $19.10/ hr on w2

Job Summary:

• The Payer Enrollment Coordinator is responsible for ensuring corporate compliance with statutory requirements for Medicare, Medicaid, and Commercial enrollment for Clinics and Providers.
• This individual will collaborate effectively with internal teams, external vendors, and payers to build strong partnerships through relationship management.
• The role requires direct interaction with Government and Commercial payers across the country, as well as with Providers, Payer Relations, Revenue Cycle Operations, Clinical Operations, and Client Field and Operations Management to ensure seamless integration of processes.
• This position will also support network management and provider relations by assisting with contract management, data analysis, provider directory maintenance, provider communication, and issue resolution.
• The coordinator plays a critical role in maintaining accurate provider information and ensuring compliance with enrollment and operational standards.

Key Responsibilities:

• Ensure compliance with Medicare, Medicaid, and Commercial payer enrollment requirements for providers and clinics.
• Develop and maintain provider- and clinic-level reporting to monitor compliance within corporate policies.
• Serve as a primary point of contact between providers, payers, and internal operations teams.
• Collaborate with Revenue Cycle Operations (Credentialing, Accounts Receivable, Billing, and Call Center) to ensure integration of enrollment processes.
• Partner with Clinical Operations and Field/Operations Management to support smooth payer integration.
• Maintain accurate and up-to-date provider information in directories and systems.
• Assist with contract management and data analysis to support payer relations and network management.
• Coordinate provider communications, education, and issue resolution.
• Provide administrative and operational support for network and provider relations initiatives.

Required Qualifications:

• 1–3 years of experience working with Government payers (Medicare/Medicaid).
• Strong problem-solving and decision-making skills.
• Ability to work independently and manage competing priorities.
• Proficiency in Microsoft Excel and Outlook.
• Strong communication and organizational skills.
• Willingness and ability to learn new systems and processes.

Preferred Qualifications:

• Bachelor’s degree in Marketing, Business, Healthcare Administration, or related field.

Education:

• High School Diploma or GED required.
• Bachelor’s degree preferred.