· Job Description:
The Provider Enrollment Analyst is responsible for reviewing provider enrollment, revalidation and change for accuracy and policy requirements. The will review the form, checklist and requirements to identify the provider request is valid and meets federal/state rule. This is a back office team but do reach out to providers who have corrections needing to be completed. Responsibilities include entering information into the computer system for purposes of researching and tracking each customer issue. Consult with support groups on more complex, non-routine customer requests and concerns. Position is under direct supervision and training will be provided.
· Review Nevada State Enrollment, Revalidation and Change forms.
· Use State regulations to determine provider meets qualification to be enrolled.
· Enter/update provider information in the Nevada MMIS system.
· Respond to questions regarding provider eligibility.
· Accurate and timely documenting and response to complex provider inquiries
· Identifies, prioritizes and resolves most questions and issues independently.
· Escalate more complex questions or issues appropriately.
· Complies with contract requirements, business unit rules and related industry and legal regulations.
· High School Diploma or equivalent
· Minimum of 1-2 years of working experience in related fields
· Prior customer service experience
· Prior office or clerical experience
· Prior Medicaid or healthcare experience preferred
· Good written and verbal communication skills, including professional telephone skills
· Ability to access and retrieve information using a PC and basic understanding of Microsoft Office products