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Gainwell Technologies logo
Gainwell Technologies

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 Specialist

Location

United States

Posted

94 days ago

Salary

0

No structured requirement data.

Job Description

Provider Enrollment Specialist

Gainwell Technologies

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This role involves acting as the enrollment liaison between Gainwell Technologies, Idaho Department of Health & Welfare (Medicaid Division), and the Idaho Medicaid provider community. - Review and process initial provider enrollment applications per State requirements - Update provider changes, certifications, and license updates - Navigate multiple systems, licensing, and medical certification websites to obtain updates - Follow up with providers on outstanding issues within contractual guidelines - Provide excellent customer service with professional verbal and written abilities while meeting documented quality standards Qualifications - Highly motivated self-starter with 3+ years’ experience working in the healthcare industry, preferably credentialing or regulatory - Strong Microsoft Office skills and experience working with business solutions software - Proven experience with issue resolution focused on research, provider enrollment, requirement compliance, and customer service - Ability to investigate complex inquiries while leveraging requirements to promote successful outcomes - Strong written and verbal communication skills - Strong organization and time management skills Requirements - This is a 100% remote position with 8-hour shifts scheduled Monday through Friday during standard business operating hours - Fast-paced, high-volume, highly visible role requiring strong attention to detail while delivering documented, high-quality analytical support within established service level agreement (SLA) timelines and operational standards - Utilize claims systems, reporting tools, and operational documentation to review pharmacy claims, validate reimbursement logic, and support claims accuracy and process improvement initiatives - Investigate complex inquiries, communicate findings and resolutions to internal and external stakeholders via secure messaging, email, or verbal communication, and document all activity within designated system tools - Work both independently and collaboratively with cross-functional teams while supporting operational goals and performance expectations Benefits - Eligible employees may participate in Gainwell’s comprehensive benefits program, which includes medical, dental, vision, 401(k), paid time off, and other employee wellness and support programs - Generous, flexible vacation policy - 401(k) employer match - Comprehensive health benefits - Educational assistance - Leadership and technical development academies to help build your skills and capabilities

Job Requirements

  • Highly motivated self-starter with 3+ years’ experience working in the healthcare industry, preferably credentialing or regulatory
  • Strong Microsoft Office skills and experience working with business solutions software
  • Proven experience with issue resolution focused on research, provider enrollment, requirement compliance, and customer service
  • Ability to investigate complex inquiries while leveraging requirements to promote successful outcomes
  • Strong written and verbal communication skills
  • Strong organization and time management skills
  • This is a 100% remote position with 8-hour shifts scheduled Monday through Friday during standard business operating hours
  • Fast-paced, high-volume, highly visible role requiring strong attention to detail while delivering documented, high-quality analytical support within established service level agreement (SLA) timelines and operational standards
  • Utilize claims systems, reporting tools, and operational documentation to review pharmacy claims, validate reimbursement logic, and support claims accuracy and process improvement initiatives
  • Investigate complex inquiries, communicate findings and resolutions to internal and external stakeholders via secure messaging, email, or verbal communication, and document all activity within designated system tools
  • Work both independently and collaboratively with cross-functional teams while supporting operational goals and performance expectations

Benefits

  • Eligible employees may participate in Gainwell’s comprehensive benefits program, which includes medical, dental, vision, 401(k), paid time off, and other employee wellness and support programs
  • Generous, flexible vacation policy
  • 401(k) employer match
  • Comprehensive health benefits
  • Educational assistance
  • Leadership and technical development academies to help build your skills and capabilities

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