Payer Enrollment Specialist

6 Months ago • 3 Years + • $60,000 PA - $70,000 PA

Job Summary

Job Description

Cartwheel is seeking a Payer Enrollment Specialist to join their team and contribute to tackling the student mental health crisis. This role involves researching, preparing, and submitting accurate health plan enrollment requests for Cartwheel and resolving related inquiries. The specialist will collaborate with school staff to improve early intervention, student engagement, and coordination of care for students. The position is full-time and remote within the U.S. Responsibilities include understanding enrollment requirements, submitting applications, following up with providers and insurance companies, maintaining documentation, and building relationships with payer representatives. The ideal candidate will have 3+ years of experience with payer enrollment processes, proficiency in Google Suite, excellent organizational skills, and a detail-oriented approach. Experience in outpatient group contracting is a plus.

Must have:

3+ years of experience with payer enrollment applications and processes
Medicaid and Commercial payer experience
Expertise in Google Suite tools (Sheets, Docs, Gmail)
Excellent time management and organizational skills
Detail-oriented
Ability to work independently and collaboratively
Strong communication and interpersonal skills

Good to have:

Experience in outpatient group contracting

Perks:

Competitive compensation
Generous PPO medical, vision, and dental coverage
Generous paid time off
Paid parental leave
401K with employer match
Meaningful equity ownership
Remote role
Annual learning stipend
Macbook

2 skills required

2 skills required for this role

Add these skills to join the top 1% applicants for this job

timeline-management

communication

Job Details

Join Cartwheel to help tackle the student mental health crisis.

Cartwheel is an early-stage company building a new kind of mental health program for kids that puts schools at the center. We see our role as supporting school staff who see kids every single day. Instead of going around them, we collaborate with them. This means:

Earlier intervention
Higher student and family engagement in care
Better coordination among the trusted adults in a student’s life

Kids shouldn't just aspire to get out of bed and drag themselves to class. They should be able to experience joy. They deserve to envision and build a life they’re excited to live. If you join Cartwheel, you’ll help make this vision a reality for millions of students across the country. We’re backed by top investors including Menlo Ventures, Reach Capital, General Catalyst, BoxGroup, and Able Partners, and we're looking for mission-driven teammates to join our team.

ABOUT THE ROLE

You will work directly with the Director of Health Plan Operations to research, prepare, and submit accurate and timely health plan enrollment requests on behalf of Cartwheel. You’ll also research and resolve payer or client related questions related to submitted enrollments.

Role type: This is a full-time position

Location: 100% remote in the U.S.

WHAT YOU’LL DO

Research insurance provider enrollment requirements by state and understand specific application requirements for each payer including prerequisites, forms required, form completion requirements, supporting documentation (DEA, CV, etc.), and regulations
Prepare and submit complete health plan enrollment requests from application retrieval thru notifying clients upon request completion. This includes group and individual applications with Medicare, Medicaid, commercial and managed care health plans
Follow up on provider enrollment applications with provider and insurance companies via telephone, email, and online portals
Interact with providers via phone or email as needed to gather information to complete applications and payer requests
Prepare and submit demographic updates as needed
Update/Maintain Payor and Provider Enrollment Trackers
Maintain and organize payor and provider document copies, NPPES/MB/CAQH/DEA/CDS and other required profiles, as well as files that are accessible to internal stakeholders
Establish close working relationships with payer representatives and contracting. departments in order to streamline future submissions and improve approval times
Enter group/individual data to credentialing system
Prepare special reports, summaries, and/or replies to inquiries by compiling data and statistics from various departmental resources
Other duties as assigned

WHO YOU ARE

3+ years experience with payer enrollment related applications and processes, including Medicaid and Commercial payers
Experience in outpatient group contracting a plus (Cartwheel is a behavioral health group practice)
Expertise in using Google Suite tools (Sheets, Docs, Gmail)
Excellent time management and organizational skills
Able to thrive in busy work environments and can work both independently and collaboratively as part of a smaller team
Detail oriented and able to ensure the complex enrollment packages are complete and correct
Takes initiative with projects, breaking them down into actionable steps and identifying areas for improvement
Able to communicate well with a wide variety of internal and external contacts at all levels of the organization
Strong interpersonal skills with the ability to foster good working relationships with others both within and outside the organization
Dedication to our mission of being the trusted mental health partner to schools!

WHY YOU’LL LOVE CARTWHEEL

Our hope is that Cartwheel will be your best career decision! In addition to tackling one of the biggest challenges of our time, at a company well-positioned to do so, you’ll have:

Mission-oriented and inclusive colleagues who will go to bat for you
Competitive compensation of $60,000-$70,000 dependent on experience
Generous PPO medical, vision, and dental coverage
Generous paid time off, including company closure from Christmas-New Years (12/25-1/1)
Paid parental leave
401K with employer match
Meaningful equity ownership stake in Cartwheel
Remote role with regular in-person retreats
$500 annual learning stipend
Macbook

Cartwheel is proud to be an equal opportunity employer. We embrace diverse backgrounds and perspectives and an inclusive work environment. We're committed to equal employment opportunity regardless of race, color, religion, ancestry, national origin, gender, sexual orientation, disability status, or veteran status.