Provider Enrollment Quality Assurance - Remote

Gainwell Technologies LLC•Any city, OH

13d•$40,900 - $58,400•Remote

About The Position

Perform complex standard and non-standard processing, quality reviews, analyses, audits, reconciliations, and reporting activities in support of outsourced services while maintaining expertise across multiple work processes. Apply knowledge of client operations and market dynamics to identify issues, recommend and implement workflow improvements, and support efficient, effective transaction processing. Research and resolve operational issues, interface with management and clients regarding resolutions, and assist with the implementation of approved process changes. Support the development, documentation, and maintenance of standard operating procedures while ensuring compliance with company confidentiality, security, and policy requirements. Provide leadership and guidance to team members through training, work delegation, activity monitoring, scheduling coordination, prioritization of workloads, and ongoing support of operational objectives.

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).

Responsibilities

Perform complex standard and non-standard processing, quality reviews, analyses, audits, reconciliations, and reporting activities in support of outsourced services while maintaining expertise across multiple work processes.
Apply knowledge of client operations and market dynamics to identify issues, recommend and implement workflow improvements, and support efficient, effective transaction processing.
Research and resolve operational issues, interface with management and clients regarding resolutions, and assist with the implementation of approved process changes.
Support the development, documentation, and maintenance of standard operating procedures while ensuring compliance with company confidentiality, security, and policy requirements.
Provide leadership and guidance to team members through training, work delegation, activity monitoring, scheduling coordination, prioritization of workloads, and ongoing support of operational objectives.