Payor Operations Specialist

We’re looking for a Payor Operations Specialist with direct experience interacting with U.S. health insurers (e.g., Optum, Aetna, Cigna, BCBS) to support provider contracting and credentialing. You’ll play a key role in helping us establish and maintain in-network contracts and keep our provider data up-to-date with insurers.

🔹 Key Responsibilities

• Manage and submit contracting and credentialing requests with U.S. insurers including Optum, Aetna, Cigna, and Blue Cross Blue Shield plans
• Communicate with payors to track contract and credentialing status updates, and resolve delays or issues
• Own and maintain provider information in CAQH and Availity portals – including submissions, re-attestations, and updates
• Ensure timely enrollment and re-enrollment of providers with accurate documentation
• Collaborate cross-functionally with provider onboarding, legal, and RCM teams
• Monitor key deadlines, maintain detailed status logs, and proactively follow up with insurers

🔹 Required Qualifications

• 2+ years of hands-on experience in U.S. healthcare payor operations
• Direct communication experience with major insurers like Optum, Aetna, Cigna, or BCBS
• Strong understanding of credentialing, contracting, and provider enrollment workflows
• Proficiency in using CAQH and Availity for provider submissions and tracking
• Strong written and verbal communication skills for insurer follow-ups
• Detail-oriented with excellent organizational and documentation habits