Senior Provider Enrollment Analyst

5 days ago

🌴 South Carolina – Remote

Although this job is listed in South Carolina, this company may be open to hiring remote in other states.

⏰ Full Time

🟠 Senior

🧐 Analyst

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Palmetto GBA

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Palmetto GBA is one of the nation’s largest providers of high volume claims and transaction processing, as well as contact center operations and technical services to the federal government and commercial customers. With a strong focus on Medicare services, they also offer administrative services, data analytics, and web development solutions, aiming to improve efficiency and value across various transactions.

Enterprise Technologies • Contact Center Operations • Training and Development • Healthcare Policy • Finance and Accounting

1001 - 5000 employees

Founded 1965

🤝 B2B

⚕️ Healthcare Insurance

🏛️ Government

📋 Description

• Functions as team leader/senior-level enrollment Analyst. • Provides leadership/guidance/direction/training to staff. • Distributes work and is available to answer questions from staff. • Acts as a resource for staff regarding any escalating issues. • Keeps manager informed of any problems/issues that need resolving. • Conducts quality reviews of completed work. • Ensures that all audits are completed, verified, and closed. • Performs analysis of audits to determine areas for training, development, and education. • Ensures that quality work instructions/forms/documents are developed/revised as needed. • Provides quality service and communicates effectively with external/internal customers in response to inquiries (correspondence, telephone). • Obtains information from internal departments, providers, government and/or private agencies, etc. to resolve discrepancies/problems. • Interprets various guidelines and provides input to required procedures. • Generates and analyzes various provider reports to management. • Participates in testing system changes related to provider files. • Contributes/participates/completes special projects as assigned.

🎯 Requirements

• Bachelor's degree equivalency: 4 years job related work experience or Associate's and 2 years job related work experience. • 2 years of provider network enrollment/certification experience. • Working knowledge of word processing, spreadsheet, and database software. • Working knowledge of provider certification process and claims processing operations/systems. • Good judgment skills required. • Effective customer service, organizational, and presentation skills required. • Demonstrated verbal and written communication skills. • Demonstrated proficiency in spelling, punctuation, and grammar skills. • Basic business math proficiency required. • Analytical or critical thinking skills required. • Ability to handle confidential or sensitive information with discretion. • In-depth knowledge of pricing methodology and discount programs. • In-depth knowledge of Medicare program instructions/regulations related to provider enrollment/issues.

🏖️ Benefits

• Subsidized health plans, dental and vision coverage. • 401k retirement savings plan with company match. • Life Insurance. • Paid Time Off (PTO). • On-site cafeterias and fitness centers in major locations. • Education Assistance. • Service Recognition. • National discounts to movies, theaters, zoos, theme parks and more.