Provider Enrollment Analyst in United States at Jobgether

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Provider Enrollment Analyst based in the United States.

This role supports critical healthcare operations by ensuring accurate and timely processing within provider enrollment and claims-related workflows. You will help evaluate claim issues, apply established policy guidelines, and support adjudication decisions that directly impact healthcare service delivery. The position plays an important role in maintaining data accuracy, compliance, and operational efficiency across business process services. You will work within structured production and quality standards, contributing to outcomes that support healthcare access for members. Operating in a remote environment, this role requires focus, consistency, and the ability to manage multiple tasks efficiently. It is well-suited for individuals who enjoy detail-oriented work within a healthcare operations setting.

• Review and evaluate claims and provider enrollment-related cases to identify errors and determine appropriate adjudication outcomes based on established policy guidelines.
• Support business process services by ensuring claims processing aligns with client requirements, quality standards, and operational procedures.
• Analyze claim issues using basic policy criteria and escalate or resolve cases as needed to ensure accurate processing decisions.
• Maintain productivity and quality targets by efficiently managing multiple claims simultaneously in a high-volume environment.
• Apply healthcare and insurance knowledge to support consistent and compliant decision-making in claims evaluation.
• Collaborate with internal teams to ensure smooth workflow execution and adherence to established guidelines and timelines.
• Work independently to meet assigned production goals while maintaining accuracy and attention to detail.

• Basic understanding of healthcare or insurance concepts, including familiarity with claims processing or provider enrollment functions.
• Strong reading and analytical skills to evaluate claim details and apply policy-based decision-making.
• Basic computer proficiency, including ability to use standard systems and tools for claims processing.
• Ability to manage multiple tasks simultaneously in a structured, deadline-driven environment.
• Strong attention to detail and ability to maintain accuracy while working through repetitive or high-volume tasks.
• Self-motivated with the ability to work independently and meet individual productivity expectations.
• Good problem-solving skills and ability to follow established procedures and guidelines consistently.
• Bonus: prior exposure to healthcare operations, insurance claims, or administrative processing environments.

• Competitive compensation aligned with experience and role responsibilities
• Fully remote work environment with potential travel opportunities (0–10%)
• Structured training and onboarding to support success in claims and enrollment processes
• Opportunity to contribute to healthcare operations that support vulnerable populations
• Exposure to healthcare claims systems and policy-based decision-making frameworks
• Stable workflow environment with clear performance and quality expectations
• Professional growth opportunities within healthcare business process services