Provider Enrollment Specialist

the South Dakota State Government • Sioux Falls, SD

4d • Onsite

About The Position

The Department of Social Services, Division of Medical Services, is seeking a detail-oriented individual with strong customer service and communication skills to join its provider enrollment team. The position enrolls providers and maintains provider data to help ensure department customers have access to medical services. It is located in Pierre or Sioux Falls and is not eligible for remote work. Employees based in Sioux Falls are expected to travel to Pierre four days per month; occasional travel to Pierre is also noted in the posting.

The specialist ensures provider eligibility by applying administrative rules and federal regulations; reviews and approves provider enrollment applications and record modifications; compares and validates data; coordinates record updates; answers provider questions; and educates providers about online enrollment processes. The position also assists with testing provider enrollment systems.

The ideal candidate is committed to public service, dependable and organized, communicates clearly, works cooperatively, and represents the Department with integrity and enthusiasm. Experience in healthcare administration and public relations is preferred.

Requirements

• Strong customer service and communication skills.
• Knowledge of business English, including grammar, spelling, and punctuation.
• Basic computer skills, including Word, Excel, and internet navigation.
• Ability to communicate information clearly and concisely.
• Ability to comprehend, properly apply, interpret, and explain departmental rules and regulations.
• Ability to compare information and recognize discrepancies.
• Ability to plan and organize work, adjust to multiple demands, prioritize tasks, and meet deadlines.
• Ability to exercise tact and discretion when dealing with others.
• Ability to gather and analyze data and use computerized data systems.
• Must attach a resume to be considered.
• Must apply online; emailed resumes or submissions will not be accepted.
• Must verify identity and eligibility to work in the United States and complete Form I-9; the state uses E-Verify.

Nice To Haves

• Experience in healthcare administration.
• Experience in public relations.
• A National Career Readiness Certificate may be submitted with the application, but is not required.

Responsibilities

• Ensure provider eligibility by applying administrative rules and federal regulations.
• Review and approve provider enrollment applications and record modifications.
• Compare and validate data, recognize discrepancies, and coordinate record updates.
• Answer provider questions and educate providers on online enrollment processes.
• Assist with testing provider enrollment systems.
• Plan and organize work, prioritize tasks, and meet deadlines.
• Apply and explain departmental rules and regulations to others.

Benefits

• $0-premium employee health insurance option.
• Eleven paid holidays.
• Vacation and sick leave accrual.
• Dental, vision, and other insurance options.
• Retirement benefits; this position is a member of Class A retirement under SDRS.
• Veterans' Preference eligibility per ARSD 55:10:02:08.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed