Provider Enrollment Quality Assurance Analyst

This is a fully remote position, open to applicants in United States.

📋 Description

• Executes both complex standard and non-standard processing and quality tasks to support outsourced services within a designated industry and functional area.

• Exhibits knowledge and skills across a range of assigned work processes.

• Utilizes expertise to promote best practice procedures and ongoing process enhancement.

• Identifies challenges and evaluates, suggests, and implements changes to procedures and workflows as needed to guarantee efficient and effective transaction processing.

• Conducts analyses and reports on findings.

• Maintains logs of relevant data and provides regular status updates.

• Compiles standard and ad-hoc reports for management and clients.

• Investigates issues and follows up with clients regarding solutions.

• Collaborates with management and clients to address problems and aids in implementing solutions as approved.

• Assists in the development and documentation of new or updated standard operating procedures.

• Manages company confidential information in accordance with established policies and guidelines.

• May offer leadership and guidance to less experienced team members.

• Oversees daily activities of employees to ensure compliance with policies and procedures.

⛳️ Requirements

• High school diploma or GED is mandatory.

• At least 2 years of experience in provider enrollment, healthcare operations, or quality assurance is required.

• Expertise in provider enrollment systems and claims processing platforms is essential.

• Strong command of Microsoft Office Suite, particularly Excel (e.g., pivot tables, formulas).

• Familiarity with healthcare compliance standards and regulatory guidelines (e.g., CMS, state, and federal regulations) is necessary.

🏝️ Benefits

• Flexible vacation policy.

• Educational assistance.

• Comprehensive health benefits.

• Leadership and technical development academies.