Provider Enrollment Analyst - Remote US

About the role

Support provider enrollment and provider revalidation operations for Medicaid healthcare programs. Ensure provider data accuracy, regulatory compliance, and fraud prevention initiatives.

Responsibilities

• Review, process, and verify provider enrollment and 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.

Requirements

• High school diploma or GED required, 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.

Qualifications

• High school diploma or GED required.
• 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.

Skills

• Provider enrollment and revalidation experience.
• Healthcare operations and compliance knowledge.
• Attention to detail and accuracy in a production environment.
• Microsoft Office proficiency, particularly Excel and Outlook.

Benefits

• Flexible vacation policy.
• 401(k) employer match.
• Comprehensive health benefits.
• Education assistance.

Pay

The pay rate for this position is $21.00/hour. The base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. The pay range for this position is $40,000 - $45,000 per year.

Schedule

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.

Company Information

Gainwell Technologies is an Equal Opportunity Employer. We define “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.”