Payer Operations Specialist

Back to jobs New Payer Operations Specialist United States Apply Who We Are Babylist is the leading registry, e-commerce, and content platform for growing families. More than 9 million people shop with Babylist every year, making it the go-to destination for seamless purchasing, trusted guidance, and expert product recommendations for new parents and the people who love them. What began as a universal registry has grown into a full ecosystem for new parents, including the Babylist Shop, Babylist Health, and a flagship showroom in Los Angeles. Hundreds of brands in baby and beyond partner with Babylist to engage meaningfully with families during one of life’s most important transitions. With over $1 billion in annual GMV, and more than $500 million in 2024 revenue, Babylist is reshaping the $320 billion baby product industry. We’re helping parents feel confident, connected, and cared for at every step. As we build the generational brand in baby, our mission remains simple: to connect growing families with everything they need to thrive.To learn more, visit www.babylist.com . Our Ways of Working Babylist thrives as a remote-first company, with HQ team members located across the U.S. and Canada. We meet in person twice a year—once as a company and once by department to strengthen the relationships that power our work. We show up consistently, stay purpose-driven, leverage AI to amplify our impact, and achieve results—together, from anywhere. What the Role Is The Payer Operations Specialist will be responsible for the operational backbone of payer contracting across Medicaid and commercial payers at Babylist Health. This role ensures that payer contracts, licenses, and credentials are submitted accurately, loaded on time, maintained in good standing, and fully operational prior to go-live. This role is critical to enabling scale—reducing operational friction, minimizing controllable denials and AR, and ensuring Babylist Health captures the full value of newly won payer contracts. You'll be joining a scrappy, collaborative team that's building the Medicaid and commercial payer strategy from the ground up, with the opportunity to define processes and bring order where it doesn't yet exist. Who You Are You have 3–6+ years of experience in payer operations, credentialing, or healthcare contracting You have experience across both Medicaid and commercial payers (strongly preferred) You're highly detail-oriented with strong project management skills and can manage multiple payer uploads and deadlines simultaneously You have strong cross-functional communication skills and can translate complex payer requirements for non-expert audiences You're scrappy and resourceful—when a payer contact goes radio silent, you find creative ways to get the information you need You thrive in startup environments where you can build processes from scratch and aren't afraid of ambiguity You're comfortable and enthusiastic about working in an AI-forward environment where AI tools are part of daily operations You embrace using technology to enhance your work while keeping people at the center How You Will Make An Impact Licensing & Credentialing Maintain detailed documentation and renewal schedules for licenses, credentials, and payer requirements Own requirements for and execution of site inspections across multiple office locations Coordinate responses to payer and regulatory requests for information in the event of an audit or otherwise Payer Onboarding & Operational Readiness Own the end-to-end payer onboarding process, ensuring payers are fully loaded prior to effective dates Partner with Billing and Ops teams to ensure claims and billing workflows are configured correctly, EFT and remittance are set up, authorization and denial management processes are in place, and reimbursement rates are clearly articulated Act as the operational point of contact during payer go-lives Contract Maintenance & Performance Support Maintain ongoing compliance and good standing across 85+ payer contracts Support contract amendments, renewals, and updates Track payer performance indicators such as rejections/denials, AR aging, patient responsibility, and cancellation rates, escalating issues as needed Cross-Functional Coordination Work closely with Payer Leads, Legal, Finance, Billing, Ops, and CS teams Ensure payer requirements are clearly documented and communicated internally Support rate change implementations and contract conversions from third-party to direct relationships Why You Will Love Working At Babylist Our Culture We work with focus and intention, then step away to recharge We believe in exceptional management and invest in tools and opportunities to connect with colleagues We build products that positively impact millions of people's lives AI is intentionally embedded in how we work, create, and scale—supporting innovation and impact Growth & Development Competitive pay and meaningful opportunities for career advancement We believe technology and data can solve hard problems We're committed to career progression and performance-based advancement Compensation & Benefits Competitive salary with equity and bonus opportunities Company-paid medical, dental, and vision insurance Retirement savings plan with company matching and flexible spending accounts Generous paid parental leave and PTO Remote work stipend to set up your office Perks for physical, mental, and emotional health, parenting, childcare, and financial planning About Compensation We use a market-based approach to compensation. The starting salary range for this role is: $85,075 to $102,090 Your starting salary will be based on your location, experience, and qualifications, with increases over time tied to performance, role growth, and internal pay equity. Important Notices Interview Process & Consent Babylist uses AI to record and transcribe all interviews for evaluation purposes in accordance with CCPA and GDPR. By participating in an interview, you consent to this recording and transcription. Interview Integrity During the interview process, we're evaluating your individual problem-solving skills, creativity, and approach to challenges. While AI tools like ChatGPT, Claude, and Cursor are part of your daily toolkit once you join Babylist, all interviews, assessments, and take-home assignments must be completed independently.  You may not use AI tools, third-party services, coaching platforms, or content-farming services during any part of the interview process unless we explicitly permit it. We will clearly communicate when AI tools are allowed for specific assessments. Any indication of third-party assistance or AI-generated responses will result in immediate disqualification. We may also verify educational credentials through third-party sources—providing false or misleading information will result in removal from consideration. Official Communication All communication will come only from the Babylist Talent Team via an @babylist.com email address. We will never request payment, bank information, or personal financial details. Be cautious of fraudulent outreach via non-company email addresses, messaging platforms (e.g., WhatsApp, Telegram), or unsolicited phone calls. Verify legitimate opportunities on our careers page. SMS Consent You may opt in to receive text message updates about your application or interviews. Opting out will not affect your application status—communication will continue via email or phone. Message and data rates may apply. Reply STOP to unsubscribe or HELP for assistance. See our Privacy Policy for more information. Create a Job Alert Interested in building your career at Babylist? Get future opportunities sent straight to your email. Create alert Apply for this job * indicates a required field Autofill with MyGreenhouse First Name * Last Name * Email * Phone Country * Phone * Resume/CV * Attach Attach Dropbox Google Drive Enter manually Enter manually Accepted file types: pdf, doc, docx, txt, rtf Preferred Name (first name only) * What are your personal pronouns? Country of Residence * Select... State or Canadian Province/ Territory of Residence * Select... City of Residence * Address * Zip Code (Postal Code) * Are you currently authorized to work for any employer in the country outlined for this role? * Select... Will you now or in the future require visa sponsorship? * Select... Current or Last Company Worked * Current or Last Job Title * LinkedIn Profile * How did you hear about Babylist as an employer? * Select... By providing your phone number in this application you may receive text messages from Babylist regarding updates about your job application, interview scheduling, and other recruitment-related information. Message and data rates may apply. You can opt out of receiving text messages by making a selection below. (Choosing to not receive text messages will not affect your application consideration) * Select... How many years of experience do you have in payer operations, credentialing, or healthcare contracting? * Select... Which types of payers have you worked with directly? * Select... When managing payer credentialing or onboarding, how many contracts or uploads have you typically handled at one time? * Select... Are you comfortable working in a startup environment where many processes are still being built and ambiguity is common? * Select... Are you comfortable using AI tools in your day-to-day work to increase efficiency? * Select... Have you personally managed payer onboarding from contract execution through operational go-live (including credentialing, billing setup, EFT, and portal access)? * Select... What in your background makes this role feel like the right next step for you? * Voluntary Self-Identification For government reporting purposes, we ask candidates to respond to the below self-identification survey. Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiring process or thereafter. Any information that you do provide will be recorded and maintained in a confidential file. As set forth in Babylist’s Equal Employment Opportunity policy, we do not discriminate on the basis of any protected group status under any applicable law. Gender Select... Are you Hispanic/Latino? Select... Race & Ethnicity Definitions If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection. As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categories is as follows: A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability. A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service. An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense. An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985. Veteran Status Select... Voluntary Self-Identification of Disability Form CC-305 Page 1 of 1 OMB Control Number 1250-0005 Expires 04/30/2026 Why are you being asked to complete this form? We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we must measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years. Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp . How do you know if you have a disability? A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever had such a condition, you are a person with a disability. Disabilities include, but are not limited to: Alcohol or other substance use disorder (not currently using drugs illegally) Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, HIV/AIDS Blind or low vision Cancer (past or present) Cardiovascular or heart disease Celiac disease Cerebral palsy Deaf or serious difficulty hearing Diabetes Disfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disorders Epilepsy or other seizure disorder Gastrointestinal disorders, for example, Crohn's Disease, irritable bowel syndrome Intellectual or developmental disability Mental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD Missing limbs or partially missing limbs Mobility impairment, benefiting from the use of a wheelchair, scooter, walker, leg brace(s) and/or other supports Nervous system condition, for example, migraine headaches, Parkinson’s disease, multiple sclerosis (MS) Neurodivergence, for example, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilities Partial or complete paralysis (any cause) Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysema Short stature (dwarfism) Traumatic brain injury Disability Status Select... PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete. Submit application