Payor Enrollment Specialist

Rothman Orthopaedics is looking for a Payer Enrollment Specialist to join our team! The Payer Enrollment Specialist is responsible for managing the enrollment process for Rothman providers with various insurance payers. They ensure that the providers are properly enrolled and credentialed with the necessary insurance plans. This involves gathering and verifying provider information as well as completing/submitting enrollment applications. The Payer enrollment Specialist will also be responsible for monitoring license, DEA and CDS applications as well as maintain CAQH for all providers assigned. If you are qualified for and interested in this role, please apply.

Hours: Mon - Fri: 7:30am - 4pm (will work 40 hrs/wk)

Location: 833 Chestnut St, Philadelphia, PA

• hybrid: will work on site 1 day per week; remote other 4 days of week

Qualifications:

• High School diploma or GED minimum education requirement
• 1 years of credentialing experience required
• Medical office operations and medical terminology
• Computer skills including, but not limited to, MS Office

Job Duties

• Assists with processing applications for Rothman physicians and clinical staff with participating insurance companies, state licensing boards, state and federal drug control agencies.
• Credentials Rothman’s physicians, physician assistants, APRNs, physical therapists, and occupational therapists.
• Maintains on-line database for insurance credentialing (CAQH).
• Communicates with insurance companies and staff on status of provider participation.
• Develops and updates provider participation grids for scheduling.
• Updates all staff on new physician approvals as they become available.
• Communicates with insurance companies on all processing issues and problems with regard to credentialing.
• Exemplifies the desired culture and philosophies of the organization.

Our Commitment to Employees:

Come work at Rothman Orthopaedics! Our employees are our single greatest asset, as such, we strive to provide a professional, nurturing environment where every member of our team can make a meaningful difference in the lives of others. This commitment to our employees has earned us the distinction as a Top Workplace in Philadelphia by the Philadelphia Inquirer year after year. Our employees enjoy competitive pay, comprehensive health and dental benefits, tuition reimbursement, paid time off, and retirement savings plans.

Rothman Orthopaedics is an Equal Opportunity employer committed to providing opportunities to all qualified applicants without regards to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law. We value developing an inclusive and equitable environment that strengthens our organization and allows us to better attract and retain a diverse workforce that is representative of our patients and our community. We model our values by creating and enacting practices that encourage participation from all backgrounds, perspectives, and experiences.

COVID-19 Policy:

As a condition of employment at Rothman Orthopaedics, it is required you receive the COVID-19 vaccination. Rothman Orthopaedics is an Equal Opportunity Employer and requests for reasonable accommodations will be considered.

Job Type: Full-time

Expected hours: No less than 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday
• No nights
• No weekends

Work Location: Hybrid remote in Philadelphia, PA 19107