Black River Health · 14 hours ago
Payer Operations Analyst
Black River Falls, WI, US
Full-time
Onsite
Mid Level
4+ years expBlack River Health is looking for a driven, detail-focused professional ready to make a real impact on how we partner with payers and deliver care to our community. As a Payer Operations Analyst, you will lead payer onboarding and enrollment activities, ensuring compliance and operational efficiency across the organization.
Health CareHealth DiagnosticsMedical
Responsibilities
Lead all payer onboarding and enrollment activities for both campuses
Ensure both the facility and all healthcare providers are enrolled with commercial and government payers, completing all reenrollment and revalidation requirements on schedule
Maintain accurate provider data across CAQH, PECOS, NPPES, payer portals, and RCM systems
Ensure timely credentialing completion and payer configuration
Serve as the primary liaison between Revenue Cycle, Finance, Operations, Credentialing, and Payer Partners
Resolve issues related to claims, denials, authorizations, credentialing, and payer setup
Translate contract terms, reimbursement methodologies, and participation requirements into workflows and system updates
Support fee schedule updates, payer configuration, and compliance alignment
Track KPIs, enrollment progress, and payer performance
Identify trends, risks, and revenue leakage
Prepare dashboards and reports to support leadership decision-making
Standardize and document processes through SOPs, process maps, and training materials
Troubleshoot complex operational issues, including enrollment delays, system errors, and reimbursement discrepancies
Qualification
Required
Associate degree required; Bachelor's preferred — or equivalent experience
4–6 years in payer operations, credentialing, enrollment, or managed care
Experience with commercial, Medicare, and Medicaid payers
Strong working knowledge of CAQH, PECOS, NPPES, payer portals, and RCM systems
Ability to analyze KPIs, identify trends, and drive process improvements
Excellent communication, organization, and cross-department collaboration skills
Commitment to regulatory and privacy compliance
Company
Black River Health
Black River Health is an accredited Critical Access Hospital and Clinic located in West Central Wisconsin, in the city of Black River Falls.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Matthew Streeter
Chief Financial Officer
Holly Winn
Chief Operating Officer
Recent News
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