Senior Associate, Credentialing and Payer Enrollment
Athenahealth
Software Engineering, Data Science
Boston, MA, USA
Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.
We’re launching a new Credentialing & Payer Enrollment service and seeking a Senior Associate to be the knowledge engine for payer research and process documentation. This hands-on, detail-oriented role owns discovery and maintenance of payer enrollment requirements, payer policies, and EDI specifications—using web-based and AI-assisted research tools to build the knowledge base that enables accurate, timely enrollments and smooth customer onboarding.
About the Role / Team
You’ll partner closely with the Senior Manager and frontline teams to translate complex payer rules into granular, actionable processes that drive enrollment and billing success. Your work directly impacts time-to-enrollment and reduces rework and escalations by ensuring documentation is accurate, current, and easily consumable by operational teams.
Core Responsibilities
Payer research (≈50%): discover and validate payer enrollment requirements, policies, and EDI specifications across a growing payer landscape.
Use web and AI-assisted research tools to find, synthesize, and verify payer information; resolve conflicts by locating authoritative sources.
Unscoped payer onboarding: research new payers as customers sign on and expand coverage for new markets.
Process design & documentation (≈40%): translate research into clear, step‑by‑step process instructions, workflows, and knowledge‑base entries frontline teams can follow.
Maintain and update a centralized knowledge base of payer requirements, enrollment workflows, and operational documentation in real time.
Analyze processes to identify gaps and inefficiencies; use data to recommend and drive continuous improvements.
Reporting & communication: prepare concise findings, recommendations, and updates for operations and stakeholders.
Continuous improvement & collaboration (≈10%): share learnings across the team, pursue professional development in payer/credentialing topics, and support margin/efficiency initiatives led by the Senior Manager.
Required Experience & Skills
2–4 years experience in payer enrollment, credentialing, EDI, claims processing, or closely related domain.
Strong familiarity with payer policies, enrollment requirements, and EDI specifications.
Excellent research skills; comfortable navigating payer portals, vendor sites, regulatory sources, and AI research tools to synthesize complex info.
Exceptional technical writing and documentation skills—able to create granular, actionable process instructions.
Highly detail‑oriented, organized, and able to manage multiple research streams concurrently.
Strong analytical skills and experience with reporting/visualization tools (Excel, Visio, Sigma, or similar).
Comfortable working independently in a startup-phase environment with evolving processes.
Familiarity with Lean/Six Sigma or other process improvement methodologies is a plus.
Knowledge of the athenahealth ecosystem is helpful.
Bachelor’s degree in healthcare administration, business, or related field — or equivalent experience.
Expected Compensation
$66,000 - $112,000The base salary range shown reflects the full range for this role from minimum to maximum. At athenahealth, base pay depends on multiple factors, including job-related experience, relevant knowledge and skills, how your qualifications compare to others in similar roles, and geographical market rates. Base pay is only one part of our competitive Total Rewards package - depending on role eligibility, we offer both short and long-term incentives by way of an annual discretionary bonus plan, variable compensation plan, and equity plans.
About athenahealth
Our vision: In an industry that becomes more complex by the day, we stand for simplicity. We offer IT solutions and expert services that eliminate the daily hurdles preventing healthcare providers from focusing entirely on their patients — powered by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.
Our company culture: Our talented employees — or athenistas, as we call ourselves — spark the innovation and passion needed to accomplish our vision. We are a diverse group of dreamers and do-ers with unique knowledge, expertise, backgrounds, and perspectives. We unite as mission-driven problem-solvers with a deep desire to achieve our vision and make our time here count. Our award-winning culture is built around shared values of inclusiveness, accountability, and support.
Our DEI commitment: Our vision of accessible, high-quality, and sustainable healthcare for all requires addressing the inequities that stand in the way. That's one reason we prioritize diversity, equity, and inclusion in every aspect of our business, from attracting and sustaining a diverse workforce to maintaining an inclusive environment for athenistas, our partners, customers and the communities where we work and serve.
What we can do for you:
Along with health and financial benefits, athenistas enjoy perks specific to each location, including commuter support, employee assistance programs, tuition assistance, employee resource groups, and collaborative workspaces — some offices even welcome dogs.
We also encourage a better work-life balance for athenistas with our flexibility. While we know in-office collaboration is critical to our vision, we recognize that not all work needs to be done within an office environment, full-time. With consistent communication and digital collaboration tools, athenahealth enables employees to find a balance that feels fulfilling and productive for each individual situation.
In addition to our traditional benefits and perks, we sponsor events throughout the year, including book clubs, external speakers, and hackathons. We provide athenistas with a company culture based on learning, the support of an engaged team, and an inclusive environment where all employees are valued.
Learn more about our culture and benefits here: athenahealth.com/careers