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Provider Enrollment Analyst

Spectraforce Technologies
United States, South Carolina, Columbia
Feb 20, 2025
Role Name: Provider Enrollment Analyst Location: Columbia, SC 29229 Work Environment: Onsite Schedule: Mon to Fri, 8am - 4:30pm, 40 hrs/week. Contract length: 3 months assignment with possible conversion Job Summary: Duties/About the role: Responsible in the provider enrollment process to review, research, analyze, and process provider enrollment applications. Ensures provider file integrity and that suppliers are in compliance with established standards and guidelines. Day to Day: 65% May perform any or all of the following in the enrollment of providers: determines the acceptability of provider enrollment applications (which may be used for initial full application, reenrollment, reactivation, change of information); provides in-depth review and verification/validation of provider data; verifies provider data by use of information databases and various organizations/agencies to ensure authenticity; sets up/tests EFT accounts. Processes/enters/updates provider data information/applications into appropriate enrollment database used in evaluating/tracking the processing of the application and/or updating of provider directories. 20% Provides quality service and communicates effectively with external/internal customers in response to inquiries (correspondence, telephone). Obtains information from internal department, providers, government and/or private agencies, etc. to resolve discrepancies/problems. Supplies enrollment applications and general information on the enrollment process to interested enrollees. 10% Contributes to and participates on special projects related to provider files. Assists Technical Support staff with testing system changes related to provider files. Assists with process improvements related to Provider Enrollment. 5% Assists with provider education and provider services training. Work environment: Typical office environment. Team Info: Our team includes individuals with a wide range of skills such as technical expertise, creative thinking, project management and interpersonal skills. Team members communicate openly and respectfully showing they value their peers input and feedback. Any extra/additional job info: Job Requirements: Required Experience: None Preferred Required EDU: Bachelor's degree or 4 years of job related work experience, to include six months of experience working in an office environment. Required Certification or licenses:NA Required Software and Tools (Hands on experience required): Microsoft Office Soft skills: Communication skills Nice to have/Preferred skills: In-depth knowledge of provider certification process, claims processing operations/systems, and pricing methodology and discount programs. In-depth knowledge of Medicare program instructions/regulations related to provider enrollment/issues. Effective presentation skills.