Provider Enrollment Internal Quality Analyst in United States at Jobgether

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Provider Enrollment Internal Quality Analyst in the United States.

This role focuses on ensuring the accuracy, integrity, and quality of provider enrollment and file maintenance processes within healthcare programs. You will play a key part in auditing operational data, identifying process gaps, and improving the overall quality of application processing workflows. Working in a detail-oriented and compliance-driven environment, you will conduct structured quality assurance reviews, support escalation handling, and contribute to root cause analysis efforts. The position requires strong analytical ability and consistency in meeting deadlines while ensuring data reliability and adherence to regulatory standards such as HIPAA. You will collaborate closely with leadership and cross-functional teams to resolve issues and enhance operational efficiency. This is an excellent opportunity for a quality-focused professional who thrives in structured, high-volume healthcare operations.

You will be responsible for conducting structured quality assurance reviews of provider enrollment and file maintenance processes, ensuring accuracy, compliance, and timely resolution of identified issues. Your work will help improve operational performance, reduce errors, and support continuous process improvement across healthcare enrollment functions.

• Conduct targeted and specialized quality audits within defined timelines.
• Review, investigate, and respond to quality audit disputes, escalating issues when necessary.
• Handle escalation requests and ensure timely, accurate resolution.
• Perform data validation and ensure accuracy, consistency, and reliability across enrollment systems.
• Conduct trend analysis and root cause investigations to identify training or process improvement needs.
• Collaborate with leadership and operational teams to address inquiries and improve workflow efficiency.
• Recommend enhancements to manual processes and support system or procedural improvements.
• Maintain strict confidentiality and compliance with HIPAA and other regulatory standards.

This role requires foundational experience in provider enrollment and quality assurance, combined with strong analytical skills and attention to detail. You should be comfortable working with data, managing deadlines, and communicating effectively in a structured healthcare operations environment.

• Minimum 6 months of combined experience in provider enrollment and internal quality assurance.
• Strong attention to detail with the ability to identify data inconsistencies and process gaps.
• Experience or familiarity with healthcare terminology and enrollment workflows (preferred).
• Proficiency with Microsoft Office Suite, particularly Excel, Word, and Outlook.
• Strong analytical and problem-solving skills, including ability to perform trend analysis.
• Ability to manage multiple tasks and meet strict deadlines in a fast-paced environment.
• Strong communication skills for interacting with leadership and cross-functional teams.
• Understanding of confidentiality requirements, including HIPAA compliance.

• Competitive salary range depending on location and experience ($44,500–$103,100 annually, varying by state)
• Comprehensive medical, dental, vision, life, and disability coverage
• 401(k) retirement savings plan with employer participation
• Paid holidays and paid time off
• Bonus opportunities (where applicable)
• Career development within a global professional services environment
• Exposure to large-scale healthcare operations and quality assurance processes
• Inclusive and diverse workplace culture with strong support for employee well-being