Provider Enrollment Analyst

Title: Provider Enrollment Analyst

Location: Columbia, SC (Work Onsite)

Duration: 4 months contract (with potential extension)

Target Start Date (based on successful onboarding completion): 01/29/2024

Shift: 8:00 AM - 5:00 PM ET - Monday - Friday

Duties:

• Responsible for the provider enrollment process to review, research, analyze, and process provider enrollment applications. Ensures provider file integrity and that suppliers comply with established standards and guidelines.
• 65% May perform any or all of the following in the enrollment of providers: determine the acceptability of provider enrollment applications (which may be used for an initial full application, enrollment, reactivation, or change of information); Provide in-depth review and verification/validation of provider data; verifies provider data by use of information databases and various organizations/agencies to ensure authenticity; sets up/tests EFT accounts. Processes/enters/updates provider data information/applications into appropriate enrollment databases used in evaluating/tracking the processing of the application and updating of provider directories.
• 20% Provides quality service and communicates effectively with external/internal customers in response to inquiries (correspondence, telephone). Obtains information from internal departments, providers, government and/or private agencies, etc. to resolve discrepancies/problems. Supplies enrollment applications and general information on the enrollment process to interested enrollees.
• 10% Contributes to and participates in special projects related to provider files. Assists Technical Support staff with testing system changes related to provider files. Assists with process improvements related to Provider Enrollment.
• 5% Assists with provider education and provider services training.

Required Skills and Abilities:

• Working knowledge of word processing, spreadsheet, and database software.
• Good judgment skills are required.
• Effective customer service and organizational skills are required.
• Demonstrated verbal and written communication skills.
• Demonstrated proficiency in spelling, punctuation, and grammar skills.
• Basic business math proficiency is required.
• Analytical or critical thinking skills required. Ability to handle confidential or sensitive information with discretion.
• Required Software and Tools: Microsoft Office.

Preferred Skills and Abilities:

• In-depth knowledge of provider certification process, claims processing operations/systems, and pricing methodology, and discount programs.
• In-depth knowledge of Medicare program instructions/regulations related to provider enrollment/issues. Effective presentation skills. Work Environment: Typical office environment.

Education:

• Required Education: Bachelor's degree or 4 years of job-related work experience, including six months of experience working in an office environment.
• Preferred Education: Bachelor's degree in Business Administration or Health Administration.

Required Skills/Experience/Education:

• 4 years of Provider Relations/Network/Claims/Reimbursement, or Contracting experience.
• In-depth understanding of Payor/Provider/Partnerships/Medicare or Medicaid/Claims
• Strong knowledge of Microsoft Office (Excel, Word, Microsoft Access, PowerPoint, Outlook), Complex Problem Solving and Strong communication skills

Job Type: Contract

Salary: $22.18 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Weekends as needed

Experience:

• Provider Enrollment: 4 years (Required)

Ability to Commute:

• Columbia, SC 29203 (Required)

Ability to Relocate:

• Columbia, SC 29203: Relocate before starting work (Required)

Work Location: In person