Provider Enrollment Specialist -Hybrid (DE)

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. 

 

Summary

Minimum 1 years’ experience in a call center environment required. Experience in health/human services and knowledge of Medicaid preferred. Provide excellent customer service primarily by telephone to Medicaid Providers and/or Members. Assist customers with coverage/claims related questions.  Accurately interpret benefits and policy provisions for beneficiaries for the providers. Conduct appropriate research and follow-up for prompt resolution of disputed claims. 

Your role in our mission

Work efficiently in a high-volume call center while maintaining a professional, polite manner.   Assist callers with coverage related questions; accurately interpret policy Analyze customer’s inquiries and determine steps for resolution, interpret benefit information, and claims processing accuracy. Keep resource information up to date and organized. Document calls in a clear and consistent manner in computer system. Conduct appropriate research and follow-up for prompt resolution of disputed claims. Relay information to appropriate departments and personnel using established communication channels and procedures.  Must be able to type and talk at the same time and navigate through multiple screens Ability to maintain confidentiality and adhere to HIPAA requirements

What we're looking for

• Participates productively as a member of a team.
• Completes tasks beyond general support level.
• Accepts instruction and direction from leadership. Ability to manage tasks and assignments without detailed direction.
• Identifies, prioritizes and resolves some issues independently, and escalates more complex questions or issues appropriately.  
• Complies with contract requirements, business unit rules and related and legal regulations         

What you should expect in this role

• Experience working in a metric driven work environment
• Experience using an auto answer system
• Experience working in the Healthcare Industry
• Experience working with Medicaid or Medicare
• Experience meeting specific service level agreements (SLA’s)
• HYBRID

        #LI-HYBRID                          #LI-JW1

 

The pay range for this position is $30,500.00 - $43,500.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

 

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.