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Provider Enrollment Analyst - Remote Us
Posted on May 25, 2026
- Nj, United States of America
- 40000.0 - 45000.0 USD (yearly)
- Full Time
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Provider Enrollment Analyst - Remote US
Summary
- Review, process, and verify provider enrollment and provider revalidation applications for accuracy, completeness, and compliance with Medicaid and CMS guidelines.
- Research, analyze, and resolve provider enrollment discrepancies by working with providers, internal departments, and external stakeholders while identifying potential fraud or inconsistent information.
- Maintain accurate provider records within enrollment systems and perform quality audits, validation checks, and reporting activities to support operational accuracy and program integrity.
- Interpret policies, procedures, and workflow requirements while supporting process improvements and updated standard operating procedures within a high-volume operational environment.
- Handle confidential provider and healthcare information in accordance with HIPAA, company security standards, and regulatory compliance requirements while meeting productivity and quality expectations.
- High school diploma or GED required, along with at least 1 year of experience in provider enrollment, provider revalidation, healthcare operations, claims processing, healthcare customer service, or administrative support.
- Familiarity with Medicaid, Medicare, provider data management, healthcare compliance, or healthcare insurance operations is preferred but not required.
- Strong attention to detail with the ability to review documentation, identify inconsistencies, and maintain accuracy in a production-driven environment.
- Basic to intermediate proficiency with Microsoft Office tools, including Excel and Outlook, along with strong organizational, communication, and multitasking skills.
- Harver Assessment Requirement: As part of the interview process, candidates must complete the Harver Assessment to evaluate communication, attention to detail, multitasking, and problem-solving capabilities relevant to the role.
- This is a 100% remote position open to candidates located anywhere within the United States.
- Employees must be available to work Monday through Friday during Eastern Time business hours, from 8:00 AM ET to 5:30 PM ET, regardless of their local time zone.
- This role supports provider revalidation and program integrity initiatives tied to evolving federal and state healthcare compliance and fraud prevention requirements.
- Daily productivity, accuracy, attendance, and quality metrics will be monitored in this fast-paced operational environment.
- Video cameras must be used during interviews and orientation, and employees must maintain a broadband internet connection with minimum speeds of 24 Mbps download and 8 Mbps upload for remote work effectiveness.
- This posting is intended for pipelining. We will accept applications on an ongoing basis.
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