Provider Enrollment Analyst / Credentialing, Fully Remote -

WPS Health • Denver, CO

392d • $40,560 - $40,560 • Remote

About The Position

The Provider Enrollment Analyst is responsible for processing applications submitted by Medicare providers, ensuring they are approved, denied, or returned in a timely manner. This role is crucial in facilitating provider enrollment in the Medicare program, which supports the senior community. The analyst will utilize online systems to verify and document enrollment information, respond to inquiries, and maintain accurate records.

Requirements

• High school diploma or equivalent.
• 1 or more years of business experience, including working in the insurance industry, claims processing, health care credentialing, billing, or medical reimbursement.

Nice To Haves

• Associate degree in business administration, insurance, healthcare, or related fields.
• 2 or more years of business experience in the insurance industry, claims processing, health care credentialing, billing, or medical reimbursement.
• Experience interpreting government regulations and applying them to current processes.
• Coursework in insurance, medical, customer service, and/or financial fields.
• 1 or more years of computer and navigation experience, preferably with dual monitors.
• Good work ethic and good attendance.
• Ability to communicate effectively over the phone.
• Experience working in a production-based environment.

Responsibilities

• Approve, deny, or return applications submitted by Medicare providers.
• Utilize online Medicare files/systems to verify, research, update, and document enrollment information.
• Respond to provider/customer enrollment telephone and written inquiries.
• Ensure all provider enrollment data is properly controlled and tracked to meet timeliness standards set by the department and CMS.
• Enter data into the online national database and internal provider files (PECOS).
• Research and verify that proper fees and inspections have been completed on certain suppliers.

Benefits

• Remote and hybrid work options available
• Performance bonus and/or merit increase opportunities
• 401(k) with dollar-per-dollar match up to 6% of salary (100% vested immediately)
• Competitive paid time off
• Health insurance, dental insurance, and telehealth services start DAY 1
• Employee Resource Groups
• Professional and Leadership Development Programs

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED