Provider Enrollment Analyst/Credentialing

WPS—A health solutions company • Fitchburg, WI

11h • Remote

About The Position

The Provider Enrollment Analyst will approve, deny, or return applications submitted by Medicare providers. This work is important in helping providers enroll in the Medicare program. The role involves utilizing online Medicare files and systems to verify, research, update, and document enrollment information. It also requires responding to provider and customer inquiries, ensuring timely processing of applications, and entering data into national databases and internal provider files. Additionally, the analyst will research and verify proper fees and inspections for certain suppliers.

Requirements

• Possess confidence in your skills navigating a computer to process applications efficiently through multiple operating systems.
• Prioritize effectively, stay on task, and work independently.
• Are comfortable critically examining, analyzing and reviewing work items in detail for accuracy.
• Possess strong communication skills, both verbal and written.
• Enjoy research and problem-solving.
• 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, including working in the insurance industry, claims processing, health care credentialing, billing or medical reimbursement.
• Experience interpreting government regulations and applying to current processes.
• Course work in insurance, medical, customer service and/or financial.
• 1 or more years of computer and navigation experience; preferably working with dual monitors.
• Good work ethic and good attendance.
• Ability to communicate effectively over the phone.
• Experience working in a production-based environment.
• Wired (ethernet cable) internet connection from your router to your computer
• High speed cable or fiber internet
• Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection

Responsibilities

• Utilize on-line 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 ensure applications are approved or denied within standards of timeliness established by department and Centers for Medicare and Medicaid Services (CMS).
• Enter data into on-line national database and internal provider files (PECOS).
• Research and verify proper fees and inspections have been completed on certain suppliers.

Benefits

• Bargaining Unit position
• 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