Provider Enrollment Analyst
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Job Description
Provider Enrollment Analyst supporting provider enrollment and revalidation operations for Medicaid healthcare programs. Ensuring data accuracy and compliance while working in a remote environment.
Responsibilities:
- Support provider enrollment and provider revalidation operations for Medicaid healthcare programs
- Review, process, and verify provider enrollment and provider revalidation applications for accuracy, completeness, and compliance with Medicaid and CMS guidelines
- Research, analyze, and resolve provider enrollment discrepancies by working with providers, internal departments, and external stakeholders while identifying potential fraud or inconsistent information
- Maintain accurate provider records within enrollment systems and perform quality audits, validation checks, and reporting activities to support operational accuracy and program integrity
- Interpret policies, procedures, and workflow requirements while supporting process improvements and updated standard operating procedures within a high-volume operational environment
- Handle confidential provider and healthcare information in accordance with HIPAA, company security standards, and regulatory compliance requirements while meeting productivity and quality expectations
Requirements:
- High school diploma or GED required
- at least 1 year of experience in provider enrollment, provider revalidation, healthcare operations, claims processing, healthcare customer service, or administrative support
- Familiarity with Medicaid, Medicare, provider data management, healthcare compliance, or healthcare insurance operations is preferred but not required
- Strong attention to detail with the ability to review documentation, identify inconsistencies, and maintain accuracy in a production-driven environment
- Basic to intermediate proficiency with Microsoft Office tools, including Excel and Outlook
- strong organizational, communication, and multitasking skills
- Harver Assessment Requirement: As part of the interview process, candidates must complete the Harver Assessment to evaluate communication, attention to detail, multitasking, and problem-solving capabilities relevant to the role.
Benefits:
- generous, flexible vacation policy
- 401(k) employer match
- comprehensive health benefits
- educational assistance
- a variety of leadership and technical development academies to help build your skills and capabilities
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