СШАPayer Operations Specialist
3 нед. назад
СШАRemote
The Payer Operations Specialist manages payer credentialing and operations to ensure provider network expansion and application processing accuracy in a women’s health platform.
Обязанности
- We're seeking an enthusiastic and process-driven Payer Operations Specialist to serve as a subject matter expert and payer escalations contact on the credentialing and payer operations team. As we expand in-network access across the country, this role directly owns the speed and accuracy of payer expansion — the difference between providers who can see members on day one and applications that stall. You will be responsible for investigating stalled applications, new payer processes, and reviewing quality across the team to ensure consistency and SLA execution.
- Location: Remote (US)
- Assist Payer Operations leadership with documenting and maintaining end-to-end SOPs for payer contracting, enrollment, and credentialing workflows — turning tribal knowledge into repeatable, auditable processes
- Implement quality controls and error-catching checkpoints that reduce rework and rejected applications
- Identify bottlenecks in the expansion pipeline and drive cycle-time improvements
- Keep enrollment and contracting trackers meticulously up to date, flag aging items and delays, and escalate blockers with proposed solutions
- Conduct persistent, proactive follow-up with payers via phone, email, and payer portals to confirm application receipt, resolve deficiencies, and push applications through to approval. You own each item until it's done
- Partner with RCM and payer strategy/business development teams in collaborative problem-solving or strategic payer initiatives.
- Assist with application submission, as needed.
Требования
- 2+ years of experience in provider enrollment, credentialing, payer contracting, or healthcare administration (internship or adjacent revenue cycle experience considered)
- Demonstrated experience building or documenting processes and SOPs
- Comfort owning metrics and reporting on pipeline throughput
- Highly independent and driven. You follow up relentlessly (including comfort calling and escalating within payer networks), manage your own queue without reminders, and don't let applications sit
- Exceptional attention to detail and organizational skills; you take pride in accurate, deadline-driven work
Будет плюсом
- Hands-on experience with payer portals and third party portals i.e. Availity
- Familiarity with commercial payer requirements (Understanding Medicare and Medicaid processes is a plus)
- Experience in multi-state telehealth, digital health, or a high-growth healthcare environment
- Exposure to credentialing standards (e.g., NCQA, CMS)
Условия
- Compensation & Career Growth $55,000 - $65,000 with opportunities for advancement
- Equity
- Professional development & employee learning programs
- Actual compensation will be determined based on a variety of factors, including but not limited to: candidate experience, location, education, certifications, and skill set. In addition to base salary, our total compensation package includes equity, comprehensive health benefits (medical, dental, vision), generous paid time off, and additional wellness and professional development perks.
- Work Environment & Flexibility 100% remote within the U.S.
- Unlimited PTO & 11 company holidays
- Health & Wellness Medical, dental, and vision benefits
- Health Savings Account (HSA) & Flexible Spending Account (FSA)
- Long- and short-term disability coverage
- Annual employee wellness stipend
- Family & Future Planning 401(k) plan
- Parental leave & family planning support benefits
- Additional Perks Company-issued laptop
- Annual work-from-home stipend
- Commuter benefits (if applicable)
- A collaborative, mission-driven culture focused on improving patient care
Другое
- Allara is a comprehensive women’s health provider that specializes in expert, longitudinal care that supports women through every life stage. Trusted by over 60,000 women nationwide, Allara makes expert healthcare accessible by connecting patients with multidisciplinary care teams that have a deep understanding of hormonal, metabolic, and reproductive care. Allara provides ongoing support for hormonal conditions like PCOS, chronic conditions like insulin resistance, and life stages like perimenopause, helping patients see improved health outcomes . As one of the fastest-growing women’s health platforms in the U.S., Allara is bridging long-overlooked gaps in healthcare for women.