Provider Enrollment Analyst

Role Overview

• 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

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