Provider Enrollment Site Visit Representative - Newark, DE - Hybrid

Date: Apr 7, 2024

Location:

Newark, DE, US, 19711-7515

Req ID: 22373

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

Summary

As Provider Enrollment Site Visit Representative - Newark, DE - Hybrid, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.

Your role in our mission

Work efficiently in a high-volume call center while maintaining a professional, polite manner. Assist callers with enrollment-related questions; accurately interpret policy, analyze customer inquiries, and determine steps for resolution. Keep resource information up to date and organized. Document calls clearly and consistently in the computer system. Conduct appropriate research and follow-up for prompt resolution of disputed enrollments. Relay information to appropriate departments and personnel using established communication channels and procedures. Must be able to type and talk at the same time and navigate through multiple screens Ability to maintain confidentiality and adhere to HIPAA requirements. At times, it may be necessary to schedule meetings with providers to assist with the enrollment process.

Process provider enrollment applications within the SLA. Review enrollment applications against customer policy to ensure appropriate enrollment in DMAP programs. Work with the customer to review applications as outlined in the policy.

Promptly respond to written inquiries from providers and customers regarding enrollment questions/concerns.

What we're looking for

Knowledge of the fundamental concepts and principles in the medical and/or insurance fields
Basic reading and analysis skills to evaluate claims and make adjudication decisions
Basic computer use skills
Ability to multi-task across multiple claims to work efficiently
Ability to work independently to meet individual production goals

What you should expect in this role

Onsite with the option for hybrid after 90 days of training.
Completes tasks beyond the general support level.
Accepts instruction and direction from leadership. Ability to manage tasks and assignments without detailed direction.
Identifies, prioritizes, and resolves some issues independently, and escalates more complex questions or issues appropriately.
Complies with contract requirements, business unit rules, and related legal regulations.

#LI-HYBRID #LI-JW1

The pay range for this position is $41,900.00 - $59,800.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.