Payer Enrollment Specialist

Brightside Health delivers life-saving virtual mental healthcare to everyone who needs it. We are powered by proprietary AI, purpose-built technology, a world-class clinician network, and a care model that rivals the best of in-person treatment. When combined with precision psychiatry and leading-edge therapeutic techniques, we’re able to improve outcomes for those with mild-to-severe clinical depression, anxiety, and other mood disorders.

We take an action-oriented, purposeful approach with everything we do and seek out team members who value collaboration and thoughtful prioritization. As a result, our organization is looking for the brightest and most innovative talent in the industry. We can promise you that, as a member of the Brightside team, you’ll have the opportunity to collaborate alongside smart and driven people while growing your professional skills.

We are looking for an experienced Payer Enrollment Specialist to join our expanding credentialing team, reporting directly to the Senior Manager, Credentialing and Enrollment. In this role, you will be responsible for enrolling all clinicians in contracted health plans including Medicare and Medicaid. You will partner closely with our commercial team and external payers. Ultimately, this role will be responsible for accurately and timely enroll clinicians in health plans across the US. Continuous and persistent follow-up with payers for statuses is important all while building effective relationships with contacts.

What you’ll be doing as a Payer Enrollment Specialist:

Initiate online and paper group and individual enrollment application submissions for new and existing contracted commercial payers including Medicare and Medicaid.

Follow-up on submitted enrollment applications to completion, escalating to leadership as needed

Respond to internal requests for information including status updates

Maintain a list of contacts with various payers

Work with providers to obtain information needed to complete enrollment applications and follow up as necessary

Maintain CAQH and PECOS profiles

Work collaboratively across departments

Ensure provider demographic data is kept up to date in credentialing system and with applicable payers

Document all activity and maintain accurate records in the credentialing system

Maintain confidentiality

Perform other duties as assigned

Requirements:

2+ years of experience enrolling with health plans including Medicare and Medicaid programs

Proficiency with applicable online portals including but not limited to CAQH, PECOS and Availity

Ability to work quickly and efficiently while maintaining accuracy

Excellent verbal, written, and social skills

Self-starter with the ability to work independently and proactively

Highly detail oriented

Able to work under pressure and adapt easily to change

Consistently create a positive work environment by being team-oriented

Excellent time and workload management skills

Experience with credentialing processes a plus

Knowledge of NCQA requirements, preferred

Benefits:

A competitive compensation

Fully paid for comprehensive health care (medical, dental, vision)

Pet Insurance

401k Plan

15 days paid vacation (accrued throughout the year), 3 paid sick days, 3 paid personal days

Paid holidays

Work remotely with flexible hours

Additional memberships and perks

Final offer amounts are determined by multiple factors including geographic location as well as candidate experience and expertise. If you have questions on compensation bands, please ask your recruiter.

Brightside Health is committed to equal employment opportunities for all team members. Every decision we make regarding employment is solely based on merit, competence, and performance. We are committed to building a team that represents a variety of backgrounds, perspectives, and skills. We realize the full promise of diversity and want you to bring your whole self to work every single day.

Research shows that underrepresented groups typically apply only if they meet 100% of the criteria listed. At Brightside, we are dedicated to fair play and encourage women, people of color, and LGBTQ+ job seekers to apply for positions even if they don’t check every box for the role.