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Provider Payer Enrollment Representative

Work from home Full-time role Hiring

• *Company FocusMD Healthcare Solutions partners directly with healthcare providers to simplify one of the most complex and frustrating parts of running a practice, dealing with payors. We work on behalf of providers, not payors, advocating for our clients and ensuring their time, revenue, and operations are protected. Our core services include credentialing, payer enrollment, contracting, and ongoing compliance support across Medicare, Medicaid, and commercial payors nationwide. We are known for navigating complex systems, resolving delays, and driving processes forward with urgency and accountability. At FocusMD, we provide white-glove consulting services and operate as a true extension of the practices we support. This means our team is expected to take ownership, think critically, and proactively manage accounts…not just complete tasks. We are a fast-paced, fully remote organization that values consistency, reliability, and strong communication. Team members are expected to maintain structured workflows, meet follow-up timelines, and ensure all work is thoroughly documented and visible across systems.** Role Description FocusMD Healthcare Solutions is seeking a Provider Payer Enrollment Representative to join our growing remote team. This role is critical in supporting our mission to advocate on behalf of providers by managing payer enrollment and credentialing processes with accuracy, urgency, and accountability. Position Overview This is a remote role with a minimum commitment of 32 hours per week. The ideal candidate is dependable, detail-oriented, and able to maintain consistent work hours with no attendance issues. This position includes client-facing interaction, requiring professionalism, strong communication skills, and the ability to represent FocusMD effectively.

Key Responsibilities

  • Manage end-to-end provider enrollment and credentialing processes across Medicare, Medicaid, and commercial payers
  • Ensure timely and accurate submission of all applications and required documentation
  • Verify provider credentials and maintain compliance with payer and regulatory requirements
  • Conduct regular follow-ups with payers to track application status and resolve delays
  • Maintain detailed, accurate documentation across internal systems and tracking tools
  • Communicate effectively with providers, payers, and internal stakeholders
  • Provide high-quality customer service and maintain strong client relationships
  • Support and deliver training related to enrollment processes

Qualifications

  • 3+ years of experience in provider enrollment, credentialing, or payer relations
  • Strong working knowledge of Medicare, Medicaid (including TX Medicaid), and commercial payers
  • Strong IPA (Independent Practice Association) knowledge, including delegated credentialing environments, payer/IPA relationships, and roster management
  • Experience working with Texas-based IPAs and networks (e.g., Genesis, BSWQA, and similar organizations)
  • Understanding of authorization workflows, network participation structures, and IPA-driven enrollment processes
  • Hands-on experience with payer portals (e.g., Availity, PECOS, CAQH, PAVE or equivalent)
  • Demonstrated ability and willingness to research payer and provider enrollment processes, navigate new portals, and identify correct submission pathways
  • Ability to manage multiple enrollments and meet strict timelines and follow-up requirements
  • Proven track record of consistent attendance, reliability, and accountability in a remote environment
  • Experience in a client-facing role with professional communication skills
  • Strong attention to detail with accurate documentation and tracking habits
  • Ability to work independently while also collaborating with a remote team
  • Comfortable in a fast-paced, high-volume environment with shifting priorities
  • Proactive mindset with the ability to identify issues and drive resolutions

Preferred (Not Required)

  • Experience supporting multi-state provider groups and multiple specialties
  • Familiarity with credentialing/enrollment platforms (e.g., MedTrainer, Symplr)

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