Provider Enrollment Quality Assurance Analyst

🕒 Julho 24

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $27.200 - $38.900 / ano

⏰ Tempo Integral

🟢 Júnior

🟡 Pleno

🔧 Engenheiro de QA (Qualidade de Software)

🚫👨‍🎓 Sem graduação necessária

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Gainwell Technologies

SiteLinkedInTodas as Vagas

10.000+ funcionários

💼 Consultoria

📦 Logística

⚕️ Seguro de Saúde

💰 Grant em 2023-06

Consulting • Logistics • Healthcare Insurance

A Gainwell Technologies é a principal provedora do país de soluções digitais e cloud-enabled em todo o ecossistema de serviços humanos e saúde pública. Com uma abordagem orientada por propósito, a Gainwell atende clientes nos 50 estados dos EUA, com foco em melhorar os desfechos em saúde e oferecer experiências intuitivas e centradas nas pessoas. Seu portfólio abrangente inclui modernização do Medicaid Enterprise, data analytics, serviços para prestadores e soluções para farmácia — tudo projetado para impulsionar o futuro da saúde e promover o bem-estar das comunidades.

Descrição

• Performs complex standard and non-standard processing and quality tasks in support of outsourced services within a specific industry and functional area • Demonstrates knowledge and skills in a variety of assigned work processes • Applies knowledge to ensure best practice procedures and continuous process improvement • Identifies issues and reviews, recommends and implements modifications to procedures and workflow as necessary to ensure efficient and effective processing of transactions • Performs analyses and reports findings • Maintains log records of pertinent data and provides periodic status reports • Prepares standard and adhoc reports for management and clients • Researches problems and follows up with the client regarding resolution • Interfaces with management and clients to resolve issues and assists in implementing same as approved • Supports development and documentation of new or revised standard operating procedures • Handles company confidential data according to policy and guidelines • May provide leadership and work guidance to less experienced personnel • Monitors daily activity of employees to ensure policy and procedures are being followed

🎯 Requisitos

• High school diploma or GED required • Minimum of 2 years of experience in provider enrollment, healthcare operations, or quality assurance • Proficiency in provider enrollment systems and claims processing platforms • Strong proficiency in Microsoft Office Suite, particularly Excel (e.g., pivot tables, formulas) • Awareness of healthcare compliance standards and regulatory guidelines (e.g., CMS, state, and federal regulations)

🏖️ Benefícios

• Flexible vacation policy • Educational assistance • Comprehensive health benefits • Leadership and technical development academies