Insurance Enrollment Specialist

Red River Pharmacy Services

Position Summary

Red River Pharmacy Services is seeking a detail-oriented and dependable Insurance Enrollment Specialist to join our team. This role is responsible for managing external pharmacy and provider payer contracts, while also supporting internal employee benefits processes, including coordinating and administering 401(k) open enrollments. The ideal candidate will bring strong experience in of insurance contracting and enrollment processes, along with a solid understanding of employee benefits administration in a fast-paced healthcare environment.

Key Responsibilities

• Enroll and recredential pharmacy and providers with insurance payer contracts
• Track and follow up on pending payer enrollments and required documentation
• Ensure provider and pharmacy payer contracts are updated and maintained in the billing system.
• Resolve payer issues and discrepancies with carriers
• Collaborate with billing, pharmacy, and administrative teams to seek network participation.
• Manage and conduct 401(k) open enrollment processes for employees
• Educate employees on 401(k) plan options, enrollment procedures, and deadlines
• Assist employees with enrollment changes, contribution updates, and general inquiries
• Coordinate with plan providers to ensure accurate setup and compliance
• Maintain confidentiality and ensure compliance with HIPAA and benefits regulations
  
  
  

Qualifications

• High school diploma or equivalent required (Associate’s degree preferred)
• Experience in insurance enrollment, recredentialing and network participation preferred
• Knowledge of Medicare, Medicaid, and commercial insurance plans for pharmacy and/or medical carrier space
• Familiarity with 401(k) plans and employee benefits enrollment processes
• Strong attention to detail and organizational skills
• Excellent communication and interpersonal skills
• Ability to manage multiple tasks and deadlines in a fast-paced environment
• Proficient in Microsoft Office and data entry systems
  
  
  

Preferred Experience

• Experience with direct insurance contracts for pharmacy network participation
• Experience with gaining network participation for providers in major medical payers
• Background in HR or employee benefits administration
• Experience working with retirement plan providers or HRIS systems
  
  
  

Work Environment

• Office-based role within the administrative team
• Fast-paced, team-oriented environment
• Frequent interaction with employees, insurance providers, and internal departments
  
  
  

Compensation & Benefits

• Competitive pay based on experience
• Health, dental, and vision insurance
• Paid time off and holidays
• Opportunities for growth and advancement