Remote - Provider Enrollment Analyst

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Requirements:

• Minimum 2+ years of experience in provider enrollment.
• Strong knowledge of the provider certification process, claims processing operations/systems, pricing methodologies, and discount programs.
• Deep understanding of Medicare/Medicaid program regulations related to provider enrollment.
• Experience presenting and communicating information effectively.
• Proficiency in Microsoft 365 (Outlook, Word, Excel, PowerPoint, etc.).
• Strong customer service and organizational skills.
• Excellent verbal and written communication abilities.
• High attention to detail, including proficiency in spelling, grammar, and punctuation.
• Strong analytical and critical thinking skills.
• Ability to manage confidential and sensitive information with discretion.

Responsibilities:

• Assessing provider enrollment applications, including initial applications, re-enrollment, reactivation, and change requests.
• Conducting in-depth verification and validation of provider data to ensure accuracy and compliance.
• Utilizing various databases and external agencies to authenticate provider information.
• Setting up and testing Electronic Funds Transfer (EFT) accounts.
• Entering, updating, and maintaining provider data in enrollment databases for tracking and application processing.
• Communicating effectively with internal and external stakeholders to address inquiries via correspondence and phone.
• Collaborating with providers, internal departments, and government/private agencies to resolve discrepancies.
• Providing enrollment applications and process guidance to potential enrollees.
• Contributing to special projects related to provider files.
• Assisting technical teams with testing system changes related to provider records.
• Supporting process improvements and initiatives related to provider enrollment.
• Assisting with provider education and training initiatives.