ESSENTIAL FUNCTIONS:

• Provider & Facility Enrollment: Prepare, complete, submit, and process initial and ongoing enrollment applications for healthcare providers and facilities with Medicare, Medicaid, commercial insurance plans, and other third-party payers.
• Application Tracking: Maintain accurate and detailed records of enrollment applications, including submission dates, application status, payer communications, approval dates, effective dates, and recredentialing deadlines.
• Weekly Payer Follow-Up: Proactively contact insurance payers at least weekly to obtain status updates, resolve outstanding issues, and ensure timely processing of enrollment applications.
• Recredentialing & Renewals: Monitor upcoming recredentialing and reenrollment deadlines and complete required applications and documentation to prevent lapses in participation.
• Documentation Management: Gather, verify, organize, and maintain required provider and facility documentation, including licenses, certifications, malpractice insurance, NPI information, and other enrollment requirements.
• Database Maintenance: Maintain accurate provider information in CAQH, PECOS, payer portals, and internal tracking systems, as applicable.
• Problem Resolution: Identify enrollment delays, missing information, or discrepancies and work proactively with payers and internal departments to resolve issues.
• Internal Communication: Collaborate with Human Resources, Revenue Cycle, Finance, and clinical leadership to support timely enrollment of new providers, facility changes, and ongoing payer participation.
• Reporting: Provide regular updates on pending applications, outstanding issues, approaching deadlines, and completed enrollments.
• Compliance: Ensure enrollment information is accurate, complete, and maintained in accordance with payer requirements and applicable regulations.

Qualifications

• High school diploma or equivalent required; additional education or training in healthcare administration, medical billing, or a related field preferred.
• Previous experience with provider credentialing, payer enrollment, medical billing, insurance verification, or healthcare administration preferred.
• Familiarity with Medicare, Medicaid, commercial insurance payers, CAQH, and PECOS is a plus.
• Strong organizational skills with exceptional attention to detail.
• Ability to manage multiple applications, deadlines, and follow-up activities simultaneously.
• Excellent written and verbal communication skills, including professional telephone communication with insurance payers.
• Proficiency in Microsoft Office, particularly Excel, and the ability to maintain accurate electronic tracking systems.
• Ability to work independently, prioritize responsibilities, and consistently follow through on outstanding tasks.
• Strong problem-solving skills and a proactive approach to identifying and resolving delays.
• Ability to maintain confidentiality and handle sensitive provider and organizational information appropriately.

We're Hiring! Payer Enrollment Assistant

Universal Primary Care | Federally Qualified Health Center (FQHC)

Universal Primary Care is seeking a highly organized, detail-oriented, and motivated Payer Enrollment Assistant to join our team!

This position plays an important role in ensuring our healthcare providers and facilities are properly enrolled and credentialed with insurance payers, allowing us to provide uninterrupted access to care for the patients and communities we serve.

The ideal candidate is someone who enjoys working with details, managing deadlines, following up consistently, and keeping processes moving forward.What We're Looking For

We're looking for someone who is organized, persistent, dependable, and takes ownership of their work.

Success in this position requires more than simply submitting applications. It means actively tracking each enrollment, following up with payers, resolving barriers, and ensuring applications continue moving toward approval.

Attention to detail, timely follow-through, and accurate recordkeeping are essential to success in this role.

Why Join Universal Primary Care?

Universal Primary Care is a mission-driven Federally Qualified Health Center serving communities throughout the Southern Tier of New York and Northwestern Pennsylvania.

Our mission is to provide compassionate, patient-centered care, and our vision is to create thriving rural communities where everyone has access to high-quality, community-driven healthcare.

As a member of our administrative team, you will play an important behind-the-scenes role in supporting our providers, protecting revenue, and ensuring patients continue to have access to the healthcare services they need.

Join Team UPC and help us make a difference in the communities we serve!