Provider Enrollment Quality Assurance Analyst - AR (Remote)

Gainwell Technologies LLC•Any city, OH

13d•$27,200 - $38,900•Remote

About The Position

As a Provider Enrollment Quality Assurance Analyst - AR (Remote) 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. Your role in our mission involves performing complex standard and non-standard processing and quality tasks in support of outsourced services within a specific industry and functional area. You will demonstrate knowledge and skills in a variety of assigned work processes, understand the business of the client and related market dynamics, and apply this knowledge to ensure best practice procedures and continuous process improvement. You will identify issues and review, recommend, and implement modifications to procedures and workflow as necessary to ensure efficient and effective processing of transactions. Additionally, you will perform analyses and report findings, interpret, audit, and reconcile reports for accuracy or completeness, and maintain log records of pertinent data and provide periodic status reports. You will also prepare standard and adhoc reports for management and clients, research problems, and follow up with the client regarding resolution. You will interface with management and clients to resolve issues and assist in implementing same as approved. You will support the development and documentation of new or revised standard operating procedures. You will handle company confidential data according to policy and guidelines and adhere to existing security policies and procedures. May provide leadership and work guidance to less experienced personnel, train and assist team members, monitor daily activity of employees to ensure policy and procedures are being followed, coordinate with managers and employees to ensure adequate scheduling, and prioritize and delegate work.

Requirements

High school diploma or GED required.
Minimum of 2 years of experience in provider enrollment, healthcare operations, or quality assurance.
Proficiency in provider enrollment systems and claims processing platforms.
Strong proficiency in Microsoft Office Suite, particularly Excel (e.g., pivot tables, formulas) for data analysis and reporting.
Awareness of healthcare compliance standards and regulatory guidelines (e.g., CMS, state, and federal regulations).
Harver Assessment Requirement: As part of our interview process, all candidates must complete the Harver Assessment. This assessment helps us evaluate key competencies relevant to the role, including communication skills, multitasking abilities, and problem-solving capabilities.

Responsibilities

Performs complex standard and non-standard processing and quality tasks in support of outsourced services within a specific industry and functional area.
Demonstrates knowledge and skills in a variety of assigned work processes.
Understands the business of the client and related market dynamics; applies knowledge to ensure best practice procedures and continuous process improvement.
Identifies issues and reviews, recommends and implements modifications to procedures and workflow as necessary to ensure efficient and effective processing of transactions.
Performs analyses and reports findings.
Interprets, audits and reconciles reports for accuracy or completeness.
Maintains log records of pertinent data and provides periodic status reports.
Prepares standard and adhoc reports for management and clients.
Researches problems and follows up with the client regarding resolution.
Interfaces with management and clients to resolve issues and assists in implementing same as approved.
Supports development and documentation of new or revised standard operating procedures.
Handles company confidential data according to policy and guidelines.
Adheres to existing security policies and procedures.
May provide leadership and work guidance to less experienced personnel.
Trains and assists team members.
Monitors daily activity of employees to ensure policy and procedures are being followed.
Coordinates with managers and employees to ensure adequate scheduling.
Prioritizes and delegates work.