At Medallion, we believe healthcare teams should focus on what truly matters—delivering exceptional patient care. That’s why we’ve built a leading provider operations platform to eliminate the administrative bottlenecks that slow healthcare organizations down. By automating licensing, credentialing, payer enrollment, and compliance monitoring, Medallion empowers healthcare operations teams to streamline their workflows, improve provider satisfaction, and accelerate revenue generation, all while ensuring superior patient outcomes.
As one of the fastest-growing healthcare technology companies—ranked No. 3 on Inc. Magazine’s 2024 Fastest-Growing Private Companies in the Pacific Region, No. 5 on LinkedIn's 2024 Top Startups in the US, a Glassdoor Best Place to Work in 2024 & 2025, and featured on The Today Show—Medallion is revolutionizing provider network management. Our CEO, Derek Lo, has been named one of the Top 50 Healthcare Technology CEOs of 2024 by The Healthcare Technology Report. Backed by $130M in funding from world-class investors like Sequoia Capital, Google Ventures, Optum Ventures, Salesforce Ventures, Acrew Capital, Washington Harbour, and NFDG, we’re on a mission to transform healthcare at scale.
We prioritize candidate safety. Please be aware that official communication will only come from @medallion.co email addresses.
About the Role:
As a Specialist, Quality Control Payer Enrollment at Medallion, you will ensure that payer enrollment files adhere to our stringent quality standards. We are looking for someone who is highly detail-oriented and able to maintain accuracy in a high-volume, fast-paced environment. This role is critical to our success, as you will be responsible for identifying errors or omissions in enrollment applications and taking corrective actions to maintain compliance with payer-specific guidelines.
Compensation for this role is between $24/hr - $31/hr depending on location and level.
Responsibilities:
- Review payer enrollment submissions to ensure data accuracy and compliance with payer-specific guidelines before submission.
- Verify that all required documents (licenses, certifications, etc.) are included and up-to-date in each enrollment file.
- Flag errors or omissions in applications and communicate with team members for quick resolution to prevent resubmission.
- Deliver real-time feedback on errors and quality issues to the enrollment team, helping maintain production flow.
- Maintain detailed records of errors, corrective actions, and trends to support ongoing quality improvements.
- Work closely with the enrollment team to address quality-related issues and ensure compliance without disrupting production timelines.
- Confirm that all submissions meet payer-specific compliance standards and documentation requirements, reducing the risk of rejections or delays.
Skills and Requirements:
- 2+ years of payer enrollment experience with applications and processes
- 2+ years of quality control experience
- Experience with CAQH, PECOS, Availity, and Medicaid (any state)
- Preferred but not required: PESC, CPCS, CPMSM, CPHQ
- Proficient in Microsoft Excel
- Strong Analytical skills: must be able to spot trends and identify outliers
- Obsessed with details: able to identify discrepancies in information, processes, and policies.
- Effectively communicate with stakeholders at various levels.
- Must be able to work cohesively in a team oriented environment and be able to foster good working relationships with others both within and outside the organization
#LI-Remote
Top Skills
Similar Jobs
What you need to know about the Los Angeles Tech Scene
Key Facts About Los Angeles Tech
- Number of Tech Workers: 375,800; 5.5% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Snap, Netflix, SpaceX, Disney, Google
- Key Industries: Artificial intelligence, adtech, media, software, game development
- Funding Landscape: $11.6 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Strong Ventures, Fifth Wall, Upfront Ventures, Mucker Capital, Kittyhawk Ventures
- Research Centers and Universities: California Institute of Technology, UCLA, University of Southern California, UC Irvine, Pepperdine, California Institute for Immunology and Immunotherapy, Center for Quantum Science and Engineering
