Provider Enrollment Analyst

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow.

Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

Summary

As a Provider Enrollment Analyst at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve a community’s most vulnerable.

Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges.

Here are the details on this position.

Your role in our mission

• Regularly review and analyze data in the Provider Enrollment, Chain, and Ownership System (PECOS) to ensure accuracy and compliance.
• Handle B-Notice communications with providers regarding issues with their enrollment.
• Manage State Escalations by liaising with state agencies to resolve enrollment-related concerns.
• Handle AFMC (Advanced Functional Medical Claims) Escalations, addressing provider concerns and inquiries.
• Conduct research on state-specific regulations and enrollment requirements to ensure compliance. Research
• Analyze provider data to identify discrepancies, errors, or gaps and work on resolutions to correct or adjust the data.
• Perform research for audits, including State, Legislative (Leg), Licensing (LN), SOC1, and Office of the Medicaid Inspector General (OMIG) audits.
• Regularly review and verify the status of background / sanctions / Deceased (LN) for providers.
• Manage and process terminations related to the Database of Excluded Individuals and Entities (DEX).
• Handle terminations in accordance with guidelines from the Office of the Medicaid Inspector General (OMIG).
• Review and process terminations for providers who are no longer at their registered address.
• Manage service tickets related to provider enrollment business unit, ensuring timely and effective resolution. Research and resolution to submitted issues.
• Address and resolve issues and inquiries from providers related to the enrollment portal.
• Provide technical support and guidance to team members, helping them troubleshoot and resolve issues.
• Create comprehensive guides and documentation for both providers and analysts, ensuring clarity and understanding of enrollment processes and requirements.
• Process provider enrollment applications and updates request for provider enrollment into AR Medicaid.

What we're looking for

• High School Diploma
• One or more years of experience in healthcare / healthcare terminology
• Knowledge of basic help desk software, computer software and Microsoft Office applications
• Intermediate to moderate MS Excel Experience

What you should expect in this role

• Fully remote opportunity with the option to work anywhere within the United States
• Schedule is Monday - Friday from 8 : 00 AM - 5 : 00 PM
• Video cameras must be used during all interviews, as well as during the initial week of orientation.

LI-REMOTE #LI-JA1 #LI-CM1

The pay range for this position is $27,200.00 - $38,900.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development.

All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance.

We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone.

Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth.

Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

We celebrate diversity and are dedicated to creating an inclusive environment for all employees.