Payor Enrollment & CredentialingLocation: Remote - USROLE SUMMARY:Supports the laboratory's revenue cycle by managing payor enrollment, maintaining credentialing documentation, and ensuring the organization remains properly registered with commercial and government payors.
WHAT YOU'LL DO:- Manage payer enrollment and re-enrollment applications for the laboratory.
- Maintain credentialing and payer documentation records.
- Track enrollment applications and follow up with payers to prevent delays.
- Monitor credentialing expiration dates and coordinate renewals.
- Work with the revenue cycle vendor to ensure payer participation is correctly reflected in billing systems.
- Ensure required documentation is submitted to payers and regulatory bodies.
- Maintain organized records of all enrollment and credentialing activity.
- Assist in resolving payer participation issues affecting billing.
- Provide updates to internal teams on credentialing and enrollment status.
BASIC QUALIFICATIONS:- Bachelor's degree required.
- 5+ years of experience in payor enrollment, credentialing, revenue cycle, healthcare administration, or a related field required.
PREFERRED QUALIFICATIONS:- Experience working with commercial and government payors.
- Knowledge of laboratory billing, healthcare revenue cycle operations, or CLIA/CAP documentation requirements.
- Strong organizational skills and attention to detail.
EXPECTATIONS, COMPETENCIES, SKILLS & ABILITIES:- Remote role based in the U.S.; able to work effectively in a remote environment with limited supervision.
- Travel up to 10%.
- Strong knowledge of payor enrollment, re-credentialing, provider enrollment workflows, and related documentation requirements.
- Demonstrated ability to manage multiple time-sensitive enrollment and credentialing timelines while maintaining accurate, complete, and audit-ready records.
- High attention to detail with the ability to verify information, identify discrepancies, and resolve documentation gaps before submission.
- Strong written and verbal communication skills, including the ability to provide clear status updates to internal stakeholders, vendors, revenue cycle partners, and payors.
- Ability to build collaborative working relationships with cross-functional teams, external vendors, payors, and regulatory or accrediting contacts.
- Comfort using payor portals, credentialing databases, provider enrollment systems, Microsoft Office applications, and tracking tools to manage workflow and reporting.
- Strong organizational, prioritization, and follow-up skills with the ability to meet deadlines in a fast-paced healthcare environment.
- Sound judgment and professionalism when handling confidential provider, company, and payor information.
- Problem-solving mindset with the ability to identify process gaps, recommend improvements, and support efficient, compliant enrollment operations.
- Commitment to accuracy, customer service, accountability, and continuous improvement.
Pay Range: $80,000 - $100,000 per year
