PAYER ENROLLMENT SPECIALIST

GCP is committed to providing exceptional gastroenterology services and optimizing provider network operations. We seek a detail-oriented and proactive Payer Enrollment Specialist to support our credentialing and network growth initiatives, ensuring timely provider enrollment, maintaining compliance, and protecting revenue integrity. 

Position Summary: 
The Payer Enrollment Specialist will manage all aspects of provider enrollment and payer network participation. This role requires close collaboration with internal teams, including Accounts Receivable (AR), to monitor and mitigate credentialing or enrollment-related denials, expand network participation, and ensure providers remain compliant with payer requirements. 

Key Responsibilities: 

• Manage initial and ongoing provider enrollment with commercial and government payers, including credentialing and re-credentialing. 

• Monitor provider enrollment status and proactively address credentialing denials or delays through collaboration with AR and other internal teams. 

• Submit new networking requests to payers to expand access and participation opportunities. 

• Ensure timely submission of documentation required by payers to prevent termination and protect reimbursement. 

• Serve as a liaison between providers and payers, clarifying requirements and resolving issues efficiently. 

• Maintain accurate and up-to-date records of provider enrollment, network status, and payer communications. 

• Identify trends in enrollment or credentialing issues and recommend process improvements. 

• Stay current with payer requirements, regulatory changes, and best practices in provider enrollment and credentialing.