Gainwell Technologies is an award-winning digital health technology company that supports the administration of healthcare and human services programs. In past flexible hiring, the
Provider Enrollment Analyst
Location
New Jersey
Posted
14 days ago
Salary
$40K - $45K / year
Seniority
Junior
Job Description
Provider Enrollment Analyst
Gainwell Technologies
• 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
Job 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
Related Guides
Related Categories
Related Job Pages
More Analyst Jobs
Customer Support and Experience Analyst – Architecture and Engineering
Vobi (YC W22)All-in-one project management software for construction SMBs
• Serve as the primary point of contact for customers via email, phone, or chat • Act as the internal focal point for resolving customer-related challenges • Triage incoming tickets and carefully analyze requests, determining whether to escalate to other teams and classifying urgency • Manage internal communication to minimize customer response times • Assist with operational procedures related to the implementation of the platform for clients • Build customer relationships through support, aiming to foster loyalty • Propose improvements to internal routines and suggest actions that increase customer satisfaction and loyalty based on support experience • Work to evolve support processes through the use of AI.
• Analyze the global application inventory to identify optimization and rationalization opportunities; • Extract, consolidate and analyze data from ServiceNow and Apptio; • Gather and analyze costs related to enterprise applications; • Perform classification, tagging and triage of data; • Develop advanced analytical models in Excel; • Support stakeholders with analyses, insights and strategic recommendations; • Work in ambiguous environments and constantly evolving scenarios; • Contribute to improving data quality and information governance; • Support cost optimization initiatives and rationalization of the applications portfolio.
• Responsible for eliciting the functional and non-functional requirements that the system to be developed must meet. • Guide, monitor and direct developers regarding the use of requirements process tools. • Capture a common vocabulary and classify the critical processes of the systems. • Participate in the construction of prototypes. • Define report specifications and audit trail recording. • Describe the user interface. • Develop supplementary specifications and a requirements management plan. • Document information classification. • Prepare supplementary specifications, glossary, requirements list, and access profile matrix for systems. • Specify functional requirements / use cases and structure the use case model. • Responsible for requirements approval meetings. • Elicit, document and prioritize preliminary requirements. • Maintain business rules.
• Specialized Support (Level 2): Assist patients with complex questions regarding treatments, clinical protocols, and side effects. • Care Coordination: Conduct follow-up consultations concerning patients' ongoing treatments. • Technical Mentorship: Support the training and technical development of more junior team members. • Patient Experience: Role focused on delivering a differentiated consultative and service experience for patients.
