Provider Enrollment Analyst Job in Columbia, SC

Broadway Ventures is seeking multiple Provider Enrollment Analysts to manage and oversee the provider enrollment application process. In this role, you will be responsible for reviewing, researching, analyzing, and processing applications to ensure accuracy and compliance. Your efforts will ensure the integrity of provider files and compliance with established standards and guidelines.

Worksite:

This position is full-time (40 hours/week), Monday-Friday. Employees will work 8:00 AM - 4:30 PM. This role is on-site in Columba, SC. (may move to work form home based on performance after 6 six months).

Key Responsibilities:

Evaluate provider enrollment applications for initial submissions, reenrollments, reactivations, and changes of information.
Conduct thorough review and validation of provider data, using information databases and external organizations/agencies to ensure authenticity.
Set up and test Electronic Funds Transfer (EFT) accounts.
Process, enter, and update provider data in the enrollment database to track application status and maintain provider directories.
Deliver quality service by effectively communicating with internal and external customers via correspondence and phone.
Resolve discrepancies by obtaining necessary information from internal departments, providers, government, and private agencies.
Provide enrollment applications and general process information to prospective enrollees.
Contribute to special projects and process improvements related to provider files and enrollment.
Support Technical Support staff with system testing and assist with provider education and training.

Required Qualifications:

Associate degree in Business or a Healthcare-related field, OR four (4) years of relevant Provider Enrollment and/or Medicare program experience.
Proficiency in word processing/data entry, spreadsheets, and database software.
Experience in a call center environment.
Good judgment and decision-making abilities.
Excellent customer service and organizational skills.
Strong verbal and written communication skills, with proficiency in spelling, punctuation, and grammar.
Basic proficiency in business math.
Ability to handle confidential or sensitive information with discretion.
Proficiency in Microsoft Office.

Preferred Qualifications:

Bachelor's degree in Business Administration or Health Administration.
Two (2) years of call center experience.
Experience with Medicare A/B MAC and PECOS.
In-depth knowledge of provider certification processes, claims processing operations/systems, pricing methodology, and discount programs.
Comprehensive understanding of Medicare program instructions and regulations related to provider enrollment.
Effective presentation skills.