Payer Enrollment Specialist

Job description

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 afull-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.