Provider Enrollment Specialist - Remote Idaho

Summary

Provider Enrollment Specialists work as the enrollment liaison between Gainwell Technologies, Idaho Department of Health & Welfare (Medicaid Division) and the Idaho Medicaid provider community (direct physicians, groups, organization administrators, compliance officers, billers, and credentialing staff). This position is responsible to educate, support, validate achievement of outlined enrollment requirements and process initial and maintenance applications. Requirements of this role include delivering the highest quality end-to-end service and support, by concise communications, through analysis and adherence to timely response deliverables. Specialists provide, build, maintain, and promote positive relationships through a vast array of consistent engagement with key stakeholders.

Your role in our mission

• Review and process initial provider enrollment applications per State requirements
• Updates provider changes, certifications, and license updates
• Navigates multiple systems, licensing and medical certification websites to obtain updates
• Follows up with providers on outstanding issues within contractual guidelines
• Provides excellent customer service with professional verbal and written abilities while meeting documented quality standards

What we're looking for

• Highly motivated self-starter with 3+ years’ experience working in healthcare industry preferably credentialling or regulatory.
• Strong Microsoft Office skills and experience working with business solutions software.
• Proven experience with issue resolution focused on research, provider enrollment, requirement compliance and customer service.
• Ability to investigate complex inquiries while leveraging requirements to promote successful outcomes.
• Strong written and verbal communication skills. Strong computer and business solutions software skills. Proficient knowledge of Microsoft Office. Strong organization and time management skills

What you should expect in this role

• This is a 100% remote position.
• The 8-hour shifts will be scheduled between 7:00am - 7:00pm MST, Monday through Friday.
• Fast-paced, high volume, high visible position requiring attention to detail, delivering documented high quality customer service and support, within specific service level agreement timelines and standards.
• Leverage provider grid, process documents and systems to verify enrollment and maintenance requirements are met and validated.
• Investigates complex inquiries, identifies resolutions, provides support and response to internal and external customers via secure message, email, and verbal communication. Captures and documents all inquiries and responses within the system tool.
• Will work independently and with a team.

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