Provider Enrollment Analyst

🕒 May 23

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

💵 $40k - $45k / year

⏰ Full Time

🟢 Junior

🧐 Analyst

🚫👨‍🎓 No degree required

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This company has sponsored H1B visas in the past.

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Healthcare Insurance • Human Services • Healthcare

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• 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