Payer Strategy Analyst

Payer Strategy Analyst

Position Summary

The Payer Strategy Analyst supports ABC’s payer relations, provider credentialing, and contract enrollment activities across both new and existing markets. This role is responsible for coordinating provider and group enrollment with payers, maintaining accurate credentialing, payer and contracting records, and supporting cross-functional teams to ensure timely and compliant provider onboarding. The Analyst plays a critical operational role in enabling market expansion, maintaining payer relationships, and supporting revenue cycle and operations through accurate enrollment, documentation, and issue resolution.

Key Responsibilities

Core Competencies

• Required

  Experience:

  • 3 years minimum of experience in RCM-based roles

  • Credentialing and enrollment with insurance companies - experience required

  • Billing, AR - experience required

  • Single Case Agreement / Network Gap Exception - experience strongly preferred

  • Understanding of ABA - experience preferred

  • Experience in a billing company and/or large-scale healthcare organization - experience strongly preferred

• Required EQ / Skillset:

  • Strong attention to detail and organizational skills

  • Ability to manage multiple enrollment activities concurrently

  • Effective written and verbal communication with internal and external stakeholders

  • Ability to work independently while adhering to established processes

  • Proficiency in tracking documentation, timelines, and payer requirements

  • A self-starter and self -motivator; this role is being added to a fast-paced team where initiatives shift and change constantly. We need someone who is flexible, independent and driven and who can operate independently once given a task (with the understanding that there will be leadership support).

  • Collaborate with cross-functional teams, auth team to facilitate SCA process (when applicable; insurance dependent) 

  • Initiate Single Case Agreement (SCA) and Network Gap Exception processes in collaboration with Authorization, Revenue Cycle, Ops, &  Finance teams.

  • Communicates with Manager, payer specific information tied to authorization and billing requirements

Provider & Group Enrollment Support

• Coordinate and submit provider and group enrollment applications for new and existing markets.

• Support new state and de novo market growth through responsibilities, including but not limited to: enrollment activities, ensuring accurate and timely setup with payers.

• Track enrollment application status, follow up on payer requests, and resolve enrollment-related issues.

• Review provider and group enrollment submissions for accuracy and completeness, identifying credentialing concerns and requesting appropriate follow-up information as needed.

• Complete EFT and ERA enrollments and communicate confirmation to collaborating internal teams.

Credentialing, Contracting & Payer Coordination

• Work closely with the Credentialing Department to align enrollment and credentialing workflows.

• Partner with contracting specialists to support group updates, demographic changes, and payer-related maintenance.

• Act as a liaison between Credentialing and Revenue Cycle Management teams to support resolution of payer enrollment and setup issues.

• Communicate with payers to respond to information requests and ensure timely enrollment completion.

Market Support & Payer Documentation

• Maintain accurate provider, group, and payer records across internal systems and databases.

• Organize and maintain payer documentation, including Single Case Agreements Agreements (SCAs), enrollment records, and related materials.

• Track renewal timelines, payer requirements, and compliance-related documentation for existing markets.

Process Support & Operational Effectiveness

• Establish, document, and follow enrollment processes and workflows appropriate to each payer and market.

• Support continuous improvement efforts by identifying enrollment inefficiencies or recurring payer issues.

• Assist with payer plan discovery and maintenance of payer-specific requirements, benefits, and market nuances as assigned.

Cross-Functional & Administrative Support

• Collaborate with internal teams including Credentialing, Contracting, Revenue Cycle, Finance, and Operations to support payer-related activities.

• Assign and coordinate tasks with outsourced or external partners as appropriate to support enrollment activities.

• Contribute to departmental projects and other related duties as assigned.

Compensation Range: $50,000 - $60,000 (salary)

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ABC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity or expression, national origin, ancestry, disability, marital status, genetic information, veteran status, or any other status protected by applicable federal, state, or local laws, including the Pennsylvania Human Relations Act (PHRA). We are committed to creating an inclusive environment for all employees.

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