Payer Operations Manager (EDI, EFT & Portal Management)

Payer Operations Manager

Compensation:LATAM:$2,000–$3,000 USD/monthSouth Africa:$2,200–$3,500 USD/monthPhilippines:$1,500–$2,300 USD/month

Exceptional candidates with deep U.S. payer connectivity and enrollment expertise may be considered above range.

Employment Type:Full-Time Independent ContractorLocation:RemoteWorking Hours:U.S. Business Hours Overlap Required

About the Company

Our client is a growing healthcare technology and financial services company focused on improving the infrastructure and operational workflows that support healthcare organizations.

As the company scales, accurate payer connectivity, provider information, electronic transactions, and payment enrollment are critical to keeping financial workflows running smoothly.

Role Overview

We are seeking an experiencedPayer Operations Managerwith hands-on expertise inU.S. healthcare payer enrollment, EDI/EFT setup, and provider and payer data management.

This is a specialized operational role for someone who understands the practical realities of working with U.S. insurance payers, clearinghouses, and healthcare portals.

You will own payer-related operational workflows, ensuring that provider and payer information is accurate, enrollments move forward, electronic transactions are properly established, and issues are followed through to resolution.

The ideal candidate is highly detail-oriented, persistent, and comfortable navigating multiple payer systems and portals.

Key Responsibilities

EDI, EFT & ERA Enrollment
* Manage end-to-end payer enrollment and connectivity workflows
* CoordinateEDI, EFT, and ERA enrollmentswith commercial and government payers
* Track enrollment status, requirements, approvals, rejections, and outstanding actions
* Coordinate with clearinghouses and payer representatives to resolve enrollment and connectivity issues
* Follow up consistently on delayed or incomplete enrollments
* Help ensure electronic claims and payment workflows are properly established

Payer Portal & Provider Data Management
* Maintain accurate provider information across payer systems and portals
* Manage provider demographic information, including:Billing addressesService addressesNPITINW-9 informationRelated provider data
* Billing addresses
* Service addresses
* NPI
* TIN
* W-9 information
* Related provider data
* Maintain and monitor access to payer and healthcare portals
* Coordinate provider information updates, attestations, roster changes, and other ongoing payer maintenance
* Identify discrepancies between provider information across systems and drive them through resolution
* Maintain accurate records of payer requirements and enrollment status

Process Improvement & Automation
* Identify repetitive or inefficient payer workflows
* Document payer-specific requirements, processes, and recurring issues
* Develop and maintain SOPs and operational documentation
* Partner with operations and technology teams to improve payer-related workflows
* Help identify opportunities to automate manual enrollment, data-management, and connectivity processes
* Translate operational requirements into clear processes that can be supported by technology

Hard Skills
* 4+ years of hands-on experience in U.S. healthcare payer operations, payer enrollment, credentialing, healthcare administration, or payer connectivity
* Direct experience withEDI and/or EFT/ERA enrollment processes
* Strong familiarity with U.S. commercial and government payers
* Experience working with healthcare payer portals and clearinghouses
* Working knowledge of healthcare EDI transactions, particularly837, 835, 270/271 and/or 276/277
* Experience maintaining provider demographic and payer information
* Strong understanding ofNPI, TIN, W-9, provider enrollment, and related healthcare data
* Experience troubleshooting payer enrollment or connectivity issues
* Strong attention to detail and data accuracy
* Comfortable working across multiple healthcare systems and web-based platforms

Soft Skills
* Exceptionally detail-oriented
* Highly organized and process-driven
* Persistent with strong follow-through
* Comfortable working independently
* Strong written and spoken English
* Strong problem-solving skills
* Able to manage multiple payer workflows simultaneously
* Comfortable communicating with payer representatives, internal stakeholders, and technical teams
* Naturally curious about systems and process improvement

About the Ideal Candidate

The strongest candidate will havedeep practical experience navigating the U.S. payer ecosystem.

They should understand how payer enrollment actually works, be comfortable working through EDI/EFT/ERA processes, and know how to resolve issues across payer portals, clearinghouses, providers, and internal teams.

This isnot a general operations manager role. We are specifically looking for someone with meaningful hands-on experience inpayer operations, enrollment, and connectivity.

Why This Role Matters

Payer connectivity and