Plume is hiring a
Payer Enrollment Specialist

Summary

The job description is for a Payer Enrollment Specialist role at Plume Health, a company focused on increasing access to healthcare for the trans community. The role involves managing payer contracts and relationships, contract and rate management, communication and data management, and interdepartmental collaboration. The ideal candidate should have relevant experience in payer contracting and provider credentialing, knowledge of healthcare regulations, strong communication skills, analytical and problem-solving abilities, organizational skills, cultural competency and sensitivity, an educational background in a related field, technology proficiency, adaptability, continuous learning, and team collaboration. The compensation range is $60k - $70k DOE with ground-floor equity, competitive benefits & perks, and a free Plume Membership.

Requirements

• A passion for and affinity with the mission of Plume, to transform healthcare for every trans life
• Proven track record in payer contracting and provider credentialing, with at least two years of experience
• Familiarity with various insurance plans and healthcare payment systems
• Proficiency in managing relationships with insurance payers
• Understanding of healthcare regulations, including HIPAA, and federal and state laws
• Familiarity with the specifics of credentialing standards and processes
• Strong communication skills: Ability to effectively communicate with various stakeholders, including insurance representatives, healthcare providers, and team members
• Analytical and Problem-Solving Abilities: Ability to identify and resolve discrepancies and issues in payer contracts
• Organizational Skills: Strong organizational and time-management skills, with an ability to prioritize tasks effectively
• Cultural Competency and Sensitivity: Demonstrated understanding and empathy towards the trans experience. Commitment to inclusivity and respectful communication

Responsibilities

• Payer Relationship Management: Build and maintain strong relationships with payer partners. Advocate for organizational interests and collaborate for mutual success. Drive performance improvement initiatives with internal teams and payer partners
• Contract and Rate Management: Maintain and update contract rates, including yearly governmental changes. Identify payment discrepancies and market trends to optimize collections
• Contract Review and Coordination: Assess initial contract terms for Operations and Finance. Review and summarize contract amendments. Coordinate document submission for new payer contracts
• Communication and Data Management: Communicate new payer developments to relevant departments. Manage payer dashboard access for new hires and terminated employees
• Interdepartmental Collaboration: Work across departments to solve contract/credentialing issues

Benefits

• $60k - $70k DOE
• Ground-Floor Equity
• Competitive Benefits & Perks
• Free Plume Membership
• Full-Time Employee Benefits and Perks: Ground-Floor Equity (Series B), Free Medical, Dental, Vision on the first of the month after you start full-time work, Unlimited PTO, 11 paid holidays and company shut-down for a week in December, 401(k), Free Plume and Mental Health Subscriptions