Provider Enrollment Analyst/Credentialing

WPS Health Solutions New•Madison, WI

1d•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. This position supports services under Centers for Medicare & Medicaid Services (CMS) contract(s). As such, the role is subject to all applicable federal regulations, CMS contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. CMS contractors and their personnel are subject to screening and background investigation prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services.

Requirements

U.S. Citizenship is required for this position due to CMS guidelines.
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
U.S. Citizenship required.
1 or more years of business experience, including working in the insurance industry, claims processing, health care credentialing, billing or medical reimbursement.
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 (can be checked at https://speedtest.net )

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.

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

Helping our providers enroll in Medicare to support the senior community.
Opportunity to earn more by being a top performer.
Flexible work hours.
Opportunity to work remotely in the comfort of your home – no driving time, gas costs, or wear and tear on your vehicle.
Experience working in an environment that serves our Nation’s military, veterans, Guard and Reserves and Medicare beneficiaries.
Working in a continuous performance feedback environment.
Remote work options available
Performance bonus and/or merit increase opportunities
401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)
Competitive paid time off
Health insurance, dental insurance, and telehealth services start DAY 1
Professional and Leadership Development Programs