Job Description

Job Location: AZ, AZ 85029GCP 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.

Qualifications
- 2+ years of experience in provider enrollment, credentialing, or payer relations.
- Knowledge of commercial and government payer enrollment processes, credentialing, and re-credentialing.
- Strong organizational skills with the ability to manage multiple priorities and deadlines.
- Excellent communication and collaboration skills for working with providers, payers, and internal teams.
- Detail-oriented with a strong focus on compliance and revenue protection.
- Proficiency with credentialing platforms such as CAQH or CredentialStream and the Microsoft Office Suite.
- Experience in healthcare revenue cycle, provider network management, or payer contracting preferred.
- Familiarity with Medicare, Medicaid, and commercial payer enrollment processes preferred.
GCP is an equal opportunity employer and does not discriminate in employment on account of race, color, religion, sex, gender, pregnancy, national origin, age, marital or familial status, sexual orientation, gender identity, disability, medical condition, veteran status, genetic information, ancestry, or any other basis protected under federal, state, or local law