Provider Enrollment Quality Assurance

🕒 Julho 23

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $40.900 - $58.400 / 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

• Perform complex standard and non-standard processing, quality reviews, analyses, audits, reconciliations, and reporting activities in support of outsourced services while maintaining expertise across multiple work processes • Apply knowledge of client operations and market dynamics to identify issues, recommend and implement workflow improvements, and support efficient, effective transaction processing • Research and resolve operational issues, interface with management and clients regarding resolutions, and assist with the implementation of approved process changes • Support the development, documentation, and maintenance of standard operating procedures while ensuring compliance with company confidentiality, security, and policy requirements • Provide leadership and guidance to team members through training, work delegation, activity monitoring, scheduling coordination, prioritization of workloads, and ongoing support of operational objectives

🎯 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) for data analysis and reporting • Awareness of healthcare compliance standards and regulatory guidelines (e.g., CMS, state, and federal regulations).

🏖️ Benefícios

• generous, flexible vacation policy • educational assistance • comprehensive leadership and technical development academies • health benefits • 401(k) employer match