Provider Enrollment Auditor

Cynet Systems • Albany, NY

1d

About The Position

This position supports provider enrollment operations. Staff members enroll, revalidate, and maintain healthcare provider files in the eMedNY system and the Provider Services Portal (PSP). They review application materials and documentation, verify provider information through federal and State databases, enter and update provider records, and maintain documents according to established procedures. The role also involves communicating with providers and meeting production and quality standards.

Requirements

• Strong computer skills, including proficiency in Microsoft Office and internet navigation.
• Strong written and verbal communication skills.
• Previous customer service experience.
• Excellent organizational skills.
• Ability to be flexible and innovative, work independently, recognize and manage priorities with minimal supervision, and work as a team member.
• High school graduate or equivalent.

Nice To Haves

• Previous experience reviewing, verifying, and validating detailed or sensitive information using web-based verification sources.
• Data entry experience.

Responsibilities

• Ensure applications and required documentation submitted in the PSP are complete, current, and valid, and that entered data complies with federal and State requirements, policies, and procedures.
• Use federal and State databases to verify information provided on applications, including Medicare's enrollment system (PECOS), the NPI Registry (NPPES), the State Education Department's Office of the Professions Verification Search, and other states' licensing verification websites.
• Contact providers through the PSP, email, or phone when information is incomplete or requires clarification, communicating clearly, concisely, and professionally.
• Enter and update provider information in eMedNY and the PSP.
• Meet production and quality standards.
• File, maintain, and upload documents according to procedures.

What This Job Offers

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