Payor Operations Specialist

Job Description

we're looking for a Payor Operations Specialist with direct experience interacting with U.S. health insurers (eg, 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