Provider Enrollment Quality Assurance Analyst

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $27.2k - $38.9k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔧 QA Engineer (Quality Assurance)

🚫👨‍🎓 No degree required

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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

• 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

🎯 Requirements

• 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)

🏖️ Benefits

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