Job Closed
This listing is no longer active.
Provider Enrollment Analyst
Location
New Jersey
Posted
73 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.
