Provider Enrollment Analyst - Remote US

Summary

As a Provider Enrollment Analyst - Remote US at Gainwell Technologies, you will support provider enrollment and provider revalidation operations for Medicaid healthcare programs. This role plays an important part in ensuring provider data accuracy, regulatory compliance, and fraud prevention initiatives tied to evolving federal and state healthcare requirements.

This is a great opportunity for candidates with experience in provider enrollment, healthcare administration, customer support, claims, data entry, or healthcare operations who are looking to grow their career in the healthcare industry. You’ll work with a collaborative team focused on protecting program integrity while supporting healthcare providers through the enrollment and revalidation process.

Your role in our mission

• 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.

What we're looking for

• 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.

What you should expect in this 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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