Payer Enrollment Specialist

Summary

Join Cartwheel, a company tackling the student mental health crisis, as a 1099 Independent Contractor. Working remotely, you'll collaborate with the Director of Health Plan Operations to manage health plan enrollment requests for students. Responsibilities include researching payer requirements, preparing and submitting enrollment applications, following up on applications, and maintaining accurate records. This role demands 3+ years of experience in payer enrollment, proficiency in Google Suite, and excellent organizational and communication skills. Cartwheel offers competitive compensation ($25-35/hour), generous benefits including medical, vision, dental, paid time off, parental leave, 401k matching, and equity ownership. The position is fully remote within the U.S. with regular in-person retreats.

Requirements

• 3+ years experience with payer enrollment related applications and processes, including Medicaid and Commercial payers
• Expertise in using Google Suite tools (Sheets, Docs, Gmail)
• Excellent time management and organizational skills
• Able to thrive in busy work environments and can work both independently and collaboratively as part of a smaller team
• Detail oriented and able to ensure the complex enrollment packages are complete and correct
• Takes initiative with projects, breaking them down into actionable steps and identifying areas for improvement
• Able to communicate well with a wide variety of internal and external contacts at all levels of the organization
• Strong interpersonal skills with the ability to foster good working relationships with others both within and outside the organization
• Dedication to our mission of being the trusted mental health partner to schools!

Responsibilities

• Research insurance provider enrollment requirements by state and understand specific application requirements for each payer including prerequisites, forms required, form completion requirements, supporting documentation (DEA, CV, etc.), and regulations
• Prepare and submit complete health plan enrollment requests from application retrieval thru notifying clients upon request completion. This includes group and individual applications with Medicare, Medicaid, commercial and managed care health plans
• Follow up on provider enrollment applications with provider and insurance companies via telephone, email, and online portals
• Interact with providers via phone or email as needed to gather information to complete applications and payer requests
• Prepare and submit demographic updates as needed
• Update/Maintain Payor and Provider Enrollment Trackers
• Maintain and organize payor and provider document copies, NPPES/MB/CAQH/DEA/CDS and other required profiles, as well as files that are accessible to internal stakeholders
• Establish close working relationships with payer representatives and contracting departments in order to streamline future submissions and improve approval times
• Enter group/individual data to credentialing system
• Prepare special reports, summaries, and/or replies to inquiries by compiling data and statistics from various departmental resources
• Other duties as assigned

Preferred Qualifications

Experience in outpatient group contracting a plus (Cartwheel is a behavioral health group practice)

Benefits

• Competitive compensation of $25-35/hour dependent on experience
• Generous PPO medical, vision, and dental coverage
• Generous paid time off, including company closure from Christmas-New Years (12/25-1/1)
• Paid parental leave
• 401K with employer match
• Meaningful equity ownership stake in Cartwheel
• Flexible and remote role with regular in-person retreats
• Annual learning stipend
• Macbook