Manage the enrollment and revalidation of behavioral health professionals for managed care, Medicare, and Medicaid plans. Maintain accurate provider records across databases and payer portals while ensuring compliance with regulatory guidelines.
The Payer Enrollment Specialist is responsible for processing, verifying and maintaining the enrollment of mental health therapists for managed care plans as well as Medicare and Medicaid programs. The ideal candidate will have knowledge of provider credentialing, behavioral health licensing requirements and a familiarity with government insurance programs. This role ensures accuracy and compliance with internal policies as well as guidelines established by regulatory agencies. What You'll Do Coordinate and manage provider enrollment, revalidation, roster management, and demographic maintenance for both delegated and non-delegated agreements behavioral health professionals (LPCs, LMFTs, LCSWs and PhDs) . Maintain accurate provider records in enrollment databases, credentialing systems, payer portals and CAQH, including enrollment activities, approvals and effective dates. Monitor the status of applications with payers to ensure timely processing and resolution of enrollment issues. Ensure compliance with payer requirements, federal and state regulations and internal company policies. Generate reports regarding enrollment status, aging applications and key performance metrics. Ensure consistency of provider data across internal systems, payer portals and delegated rosters. Work with internal teams for enrollment issues with commercial payers. Assist with preparation for payer delegation audits and corrective action plan when necessary. Communicate enrollment status updates to both providers and internal stakeholders.
Full Time Employee: 40 hour work week Hybrid role; onsite 3 days per week Who You Are High School Diploma or equivalent required; Associate’s or Bachelor’s degree preferred. Minimum of 3 years experience of behavioral health payer enrollment Strong attention to detail, organizational skills, and ability to handle sensitive information. Demonstrated skills in problem solving, analysis and resolution Strong analytical, organizational and problem solving skills. Excellent written and verbal communication abilities. Ability to prioritize workload effectively and meet deadlines Ability to work quickly and efficiently while maintaining accuracy Ability to remain flexible and adapt to changes in a fast-paced environment
Competitive salary and benefits package, including Medical, Dental, Vision, and a 401K plan with a Company Match. Employee Assistance Programs, including Mental Health, Wellness, Financial, Legal, and Pet Insurance Generous PTO policy with 11 observed company holidays 12 weeks of fully paid parental leave for the primary caregiver, and 6 weeks of fully paid leave for the secondary caregiver, for qualifying full-time employees. Energetic start-up environment with onsite exercise facility The expected pay range for this position is $60,000-$75,000 per year. Actual pay will be based on the individual’s qualifications and experience.
Market context
Behavioral health positions in Illinois often draw steady interest because employers look for licensed or graduate-prepared candidates who can work in clinical, community, or care-coordination settings. This role is competitive because the required background is specific—either a master’s degree in a human services field or an active Illinois RN license, with behavioral health experience preferred. Review the AI-summarized requirements and benefits here to save research time, then confirm your licensure, degree, and setting experience before applying.
