Medicare & Medicaid Enrollment Analyst

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Curana Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🤝 B2B

⚕️ Healthcare Insurance

B2B • Healthcare Insurance

Curana Health is a healthcare provider focused on senior primary care and on-site clinical services in skilled nursing and senior living communities. The company partners with operators, payors, and Medicare Advantage plans to implement value-based care models, offering physician-led care teams, medical director services, care coordination (including RPM and APCM), behavioral health, and palliative care. Curana emphasizes reducing hospital readmissions, falls, and polypharmacy while improving resident satisfaction through integrated, community-based care supported by technology and payor partnerships.

📋 Description

• Prepare, submit, and monitor individual and group Medicare revalidations through PECOS. • Manage Medicare revalidations and enrollment maintenance requests. • Track PTAN assignments, effective dates, and approval statuses. • Coordinate electronic signatures and supporting documentation required for Medicare revalidations. • Maintain compliance with CMS regulations and Medicare Administrative Contractor (MAC) requirements. • Submit revalidation Medicaid applications for both individual providers and provider organizations. • Coordinate state-specific Medicaid enrollment requirements and supporting documentation. • Monitor application status and resolve deficiencies with state Medicaid agencies. • Develop and maintain tracking systems for all Medicare and Medicaid revalidation activities. • Monitor revalidation due dates, enrollment expirations, and regulatory deadlines. • Conduct routine follow-up with Medicare contractors and state Medicaid agencies. • Ensure all enrollment milestones are documented and reported accurately. • Escalate delayed or high-risk applications to leadership as appropriate. • Ensure all activities comply with CMS, Medicare, Medicaid, and organizational requirements. • Maintain complete and audit-ready enrollment files and supporting documentation. • Assist with internal audits, accreditation reviews, and regulatory requests. • Monitor changes in Medicare and Medicaid enrollment policies and communicate impacts to stakeholders. • Implement process improvements to enhance enrollment efficiency and accuracy. • Serve as the primary resource for Medicare and Medicaid revalidation guidance. • Collaborate with Billing, Revenue Cycle, Credentialing, Compliance, and Operations teams. • Research and resolve enrollment-related billing delays, claim denials, and reimbursement issues. • Provide status updates and reporting to leadership and operational stakeholders.

🎯 Requirements

• High School Diploma or equivalent required • Minimum of three years of Medicare and Medicaid experience • Experience managing both provider and organizational/group enrollments • Strong knowledge of CMS enrollment regulations, PECOS, Medicare revalidation requirements, and state Medicaid enrollment processes • Experience working with enrollment tracking systems and provider management platforms • Strong organizational, analytical, and problem-solving skills

🏖️ Benefits

• Health insurance • Professional development opportunities