Homeoffice Payor Enrollment Specialist (SC/NC/GA Remote only) chez OB Hospitalist Group (OBHG)

Join our Mission:  Join the forefront of women's healthcare with OB Hospitalist Group (OBHG), the nation’s largest and only dedicated provider of customized obstetric hospitalist programs. Celebrating over 19 years of pioneering excellence, OBHG has transformed the landscape of maternal health. Our mission-driven company offers a unique opportunity to elevate the standard of women's healthcare, providing 24/7 real-time triage and hospital-based obstetric coverage across the United States. If you are driven to join a team that makes a real difference in the lives of women and newborns and thrive in a collaborative environment that fosters innovation and excellence, OBHG is your next career destination!

Payor Enrollment Specialist Position Summary: Processes credentialing and re-credentialing applications and Credentialing Vendor requests for OBHG health care providers. Preference for candidates residing SC, NC, and GA. 

• Hourly Compensation: $21.00 - $24.00 (based on experience) 
• Fully remote work, equipment provided.

What We Offer - More of The Good Stuff:

• A mission based company with an amazing company culture.
• Paid time off & holidays so you can spend time with the people you love.
• Medical, dental, and vision insurance for you and your loved ones.
• Health Savings Account (with employer contribution) or Flexible Spending Account options.
• Paid Parental Leave
• Employer Paid Basic Life and AD&D Insurance.
• Employer Paid Short- and Long-Term Disability.
• Optional Short Term Disability Buy-up plan.
• 401(k) Savings Plan, with ROTH option.
• Legal Plan.
• Identity Theft Services.
• Mental health support and resources.
• Employee Referral program – join our team, bring your friends, and get paid.

Payor Enrollment Specialist Responsibilities:  Essential 

• Maintain credentialing information by reviewing, entering and following up on missing
• Establish and maintain professional relationship with providers, insurance providers, client contacts and account service/credential
• Submit and follow up on request for signatures in a timely
• Respond to credentialing
• Contact and respond to request to/from hospitals and health payers for verification of provider's credentials, ensuring credentialing and licensing processes are completed
• Responsible for the processing and preparation of the applications for insurance payer participation with the ability to manage multiple facilities'/payers' enrollment requirements, which includes non-application requests that are indicated by OBHG staff and/or facility/payer.
• Track credentialing application
• Maintains providers/practitioner files including maintenance of the OBHG provider database, individual CAQH profiles and providers rosters by identifying who may need updating or re­ credentialing and process
• Maintains and updates CRM, Mail and Utility Logs for provider's licensure, board certifications and certificate of
• Escalate non-responsiveness of MD to Supervisor with documentation of
• Meet required turnaround times and accuracy
• Ensure all Protected Health Information is kept in a secure location at all times and maintain Compliance by communicating credentialing request, status and issues to the Corporate Compliance
• Participate in the credentialing committee as
• Perform other duties as assigned by Payer Enrollment Manager and/or Management

Payor Enrollment Specialist Essential Skills/Credentials/Experience/Education

• Five years’ experience in payor enrollment for Medicaid and Managed Care payors.
• Strong organizational skills and attention to
• A minimum of a High School Diploma or equivalent is required; some college or equivalent experience is preferred.

Preferred Skills/Credentials/Experience/Education

• Strong telephone
• Strong computer skills, proficient in Word, Excel &
• Preferred understanding of medical
• CPCS credentialing

Physical Demands (per ADA guidelines)

•  Physical Demands: Sitting for long periods of Occupation requires this activity more than 66% of the time (2.6+ hrs/day)
• Travel Demands: May require occasional travel to corporate headquarters in Greenville, SC