Payer Operations Specialist

The role

The Payer Operations Specialist serves as a subject matter expert and payer escalations contact on the credentialing and payer operations team. This person will manage payer expansion speed and accuracy by investigating stalled applications and reviewing quality to ensure SLA execution.

What you will do

• Assist Payer Operations leadership with documenting and maintaining end-to-end SOPs for payer contracting, enrollment, and credentialing workflows
• Implement quality controls and error-catching checkpoints
• Identify bottlenecks in the expansion pipeline and drive cycle-time improvements
• Keep enrollment and contracting trackers up to date
• Flag aging items and delays and escalate blockers with proposed solutions
• Conduct proactive follow-up with payers via phone, email, and payer portals
• Partner with RCM and payer strategy/business development teams
• Assist with application submission

Required qualifications

• 4+ years of experience in provider enrollment and credentialing
• Demonstrated experience building or documenting processes and SOPs
• Comfort owning metrics and reporting on pipeline throughput
• Highly independent and driven
• Exceptional attention to detail and organizational skills

Nice to have

• Hands-on experience with payer portals and third-party portals i.e. Availity
• Familiarity with commercial payer requirements (Understanding Medicare and Medicaid processes is a plus)
• Experience in multi-state telehealth, digital health, or a high-growth healthcare environment
• Exposure to credentialing standards (e.g., NCQA, CMS)

Benefits

• Equity
• Professional development & employee learning programs
• Unlimited PTO
• 11 company holidays
• Medical, dental, and vision benefits
• Health Savings Account (HSA) & Flexible Spending Account (FSA)
• Long- and short-term disability coverage
• Annual employee wellness stipend
• 401(k) plan
• Parental leave & family planning support benefits
• Company-issued laptop
• Annual work-from-home stipend

About the company

Allara is a comprehensive women’s health provider that specializes in expert, longitudinal care that supports women through every life stage. It is a fast-growing women’s health platform in the U.S. that connects patients with multidisciplinary care teams.