Provider Enrollment Specialist II
4 weeks ago
Type of Requisition:
RegularClearance Level Must Currently Possess:
NoneClearance Level Must Be Able to Obtain:
NoneSuitability:
Public Trust/Other Required:
NoneJob Family:
Healthcare ClaimsJob Qualifications:
Skills:
Medicaid Programs, Microsoft Office, Operations Processes, Provider Enrollment, State RegulationsCertifications:
Experience:
1 + years of related experienceUS Citizenship Required:
NoJob Description:
Healthcare Claims Assistant II
Drive better health outcomes for our clients as a Healthcare Claims Assistant II at GDIT. Here, your work will impact many as you deliver healthcare expertise and services where they are needed most. Own this opportunity to advance not just research, but also your personal career growth. GDIT is currently seeking a Provider Enrollment Specialist II in Raleigh NC to join our team. In this role you will be a change agent by conducting operational audits and verifying that operational procedures are followed correctly for the Provider Enrollment Section. This section is responsible for enrolling providers for the NC Medicaid Programs. This involves ensuring that providers are licensed and accredited for the services enrolling to provide and do not have a criminal background. At GDIT, people are our differentiator. As a Healthcare Claims Assistant II, you will help ensure today is safe and tomorrow is smarter.
RESPONSIBILITIES:
Process provider enrollment applications to ensure new and currently enrolled providers are within compliance within NC State regulations.
Validate the qualifications of licensed professionals, organizational members or organizations
Render a determination that an organization or entity meets the established qualifications, requirements and/or standards to provide a service or procedure as outlined in the State business rules/desk procedures.
Perform and assess the background check through Lexis Nexis, AAR and PPTD.
Perform source verification of licensure, certification, endorsements and accreditations through Lexis Nexis or State Licensure Board.
Deny providers that do not meet the requirements.
Meet performance quality standards on a daily basis.
Meet performance quantity standards on a daily basis.
QUALIFICATIONS:
Requires Skills and Experience
Requires 2 years administrative experience
Knowledge of NC Medicaid or Healthcare
Working knowledge of NCTracks
Working knowledge of provider enrollment requirements
Proficient with Microsoft suite
Desired Skills and Experience:
Credentialing experience
Customer service experience
Experience working with fax machines, computer software, and telephone technology
Attention to detail
ATTRIBUTES FOR SUCCESS:
Strong verbal and written communication
HOW A HEALTHCARE CLAIMS ASSISTANT II WILL MAKE AN IMPACT
Processes healthcare claims in an accurate and timely manner.
WHAT YOU’LL NEED TO SUCCEED:
Education: High School Diploma/GED
Required Experience: 1+ years of related experience
Security Clearance Level: No
Location: Hybrid (In office 1x per week; Raleigh, NC)
US Citizenship Required
GDIT IS YOUR PLACE:
Full-flex work week to own your priorities at work and at home
401K with company match
Comprehensive health and wellness packages
Internal mobility team dedicated to helping you own your career
Professional growth opportunities including paid education and certifications
Cutting-edge technology you can learn from
Rest and recharge with paid vacation and holidays
Scheduled Weekly Hours:
40Travel Required:
NoneTelecommuting Options:
HybridWork Location:
USA NC Raleigh - 2610 Wycliff Rd (NCS010)Additional Work Locations:
USA NC RaleighTotal Rewards at GDIT:
Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 30,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 30 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology.We connect people with the most impactful client missions, creating an unparalleled work experience that allows them to see their impact every day. We create opportunities for our people to lead and learn simultaneously. From securing our nation’s most sensitive systems, to enabling digital transformation and cloud adoption, our people are the ones who make change real.GDIT is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other protected class.-
Provider Enrollment Specialist II
4 weeks ago
Raleigh, United States General Dynamics Information Technology Full timeReq ID: RQ186087 Type of Requisition: Regular Clearance Level Must Be Able to Obtain: None Public Trust/Other Required: None Job Family: Healthcare Claims Skills: Medicaid Programs,Microsoft Office,Operations Processes,Provider Enrollment,State Regulations Experience: 1 + years of related experience Job...
-
Provider Enrollment Specialist II
4 weeks ago
Raleigh, United States General Dynamics Information Technology Full timeType of Requisition:RegularClearance Level Must Currently Possess:NoneClearance Level Must Be Able to Obtain:NoneSuitability:Public Trust/Other Required:NoneJob Family:Healthcare ClaimsJob Qualifications:Skills:Medicaid Programs, Microsoft Office, Operations Processes, Provider Enrollment, State RegulationsCertifications:Experience:1 + years of related...
-
Provider Enrollment Specialist
2 weeks ago
Baton Rouge, LA , USA, United States Highmark Health Full timeJob SummaryWe are seeking a highly skilled and detail-oriented Provider Enrollment Specialist to join our team at Highmark Health. In this role, you will be responsible for coordinating and facilitating the enrollment of Allegheny Clinic professional providers with various payers for professional services reimbursement.Key ResponsibilitiesCoordinate and...
-
Enrollment Coordinator II
1 month ago
Pittsburgh, PA , USA, United States CapLeo Global Full time{"title": "Enrollment Coordinator II", "content": "Job SummaryAt CapLeo Global, we are seeking a highly skilled Enrollment Coordinator II to join our team. As a key member of our enrollment team, you will play a critical role in working with our new and existing Medicare member clients to process enrollments and various other requests.The successful...
-
Enrollment Coordinator II
4 weeks ago
Pittsburgh, PA , USA, United States CapLeo Global Full timeJob Title: Enrollment Coordinator IIAt CapLeo Global, we are seeking a highly skilled Enrollment Coordinator II to join our team. As a key member of our enrollment team, you will play a critical role in working with our new and existing Medicare member clients to process enrollments and various other requests.The Enrollment Coordinator II will work in...
-
Enrollment Coordinator II
3 weeks ago
Pittsburgh, PA , USA, United States Global Pharma Tek Full timeJob Title: Enrollment Coordinator IIGlobal Pharma Tek is seeking a highly skilled Enrollment Coordinator II to join our team. As a key member of our enrollment team, you will play a critical role in ensuring the accurate and timely processing of enrollments and various other requests.Key Responsibilities:Identify and process different types of documents and...
-
Enrollment Specialist
7 days ago
Raleigh, North Carolina, United States East Coast Migrant Head Start Project Full timeEnrollment Specialist Job DescriptionWe are seeking a highly skilled Enrollment Specialist to join our team at the East Coast Migrant Head Start Project in Raleigh, NC. This is a full-time position that requires excellent communication skills and proficiency in Microsoft Office applications.Key Responsibilities:Ensure accurate and timely completion of...
-
Enrollment Specialist
4 weeks ago
Miami, FL , USA, United States Public Health Trust of Dade Co Full timeJob SummaryWe are seeking a highly skilled Enrollment Specialist to join our team at the Public Health Trust of Dade Co. As an Enrollment Specialist, you will play a critical role in ensuring that patients receive the financial assistance they need to access quality healthcare services.Key ResponsibilitiesAssess patients' financial eligibility for Medicaid,...
-
Raleigh, North Carolina, United States VirtualVocations Full timeHealthcare Credentialing and Enrollment Specialist **Key Responsibilities:** • Manage the credentialing process for healthcare providers • Initiate and complete enrollment applications with insurance plans • Maintain accurate provider information in databases **Required Qualifications:** • Bachelor's degree in Healthcare Administration, Business...
-
Open Enrollment Specialist
1 month ago
Greensboro, NC , USA, United States The LaSalle Group Full timeOpen Enrollment AdvisorWe are seeking a highly organized and detail-oriented individual to serve as an Open Enrollment Advisor. As a key member of our team, you will be responsible for providing exceptional customer service to clients related to healthcare benefits, life insurance benefits, and disability plans.Key Responsibilities: Educate and advise...
-
Open Enrollment Specialist
4 weeks ago
Greensboro, NC , USA, United States The LaSalle Group Full timeOpen Enrollment AdvisorWe are seeking a highly organized and detail-oriented individual to serve as an Open Enrollment Advisor. As a key member of our team, you will be responsible for providing exceptional customer service to clients related to healthcare benefits, life insurance benefits, and other human resource services.Key Responsibilities: Educate and...
-
Department Enrollment Specialist
2 weeks ago
Pittsburgh, PA , USA, United States University of Pittsburgh Full timeJob SummaryThe University of Pittsburgh is seeking a highly motivated and organized Department Enrollment Specialist to join our team. As a key member of our admissions team, you will play a critical role in recruiting and enrolling students into our academic programs.Key ResponsibilitiesDevelop and implement recruitment strategies to attract a diverse pool...
-
Open Enrollment Specialist
1 week ago
Greensboro, NC , USA, United States The LaSalle Group Full timeOpen Enrollment AdvisorWe are seeking a detail-oriented and proactive individual to join our team as an Open Enrollment Advisor. This role is based out of our Greensboro, NC office and involves serving as a point of contact for clients related to healthcare benefits, life insurance benefits, disability plans, and other human resource services.Key...
-
Open Enrollment Specialist
4 weeks ago
Greensboro, NC , USA, United States The LaSalle Group Full timeOpen Enrollment AdvisorLaSalle Network is seeking a detail-oriented and proactive individual to join their team as an Open Enrollment Advisor. This role is based out of their Greensboro, NC office and involves serving as a point of contact for clients related to healthcare benefits, life insurance benefits, disability plans, and other human resource...
-
Payer Enrollment Specialist
2 weeks ago
Grand Rapids, MI , USA, United States University of Michigan Health-West Full timePayer Enrollment SpecialistUniversity of Michigan Health-West is seeking a highly skilled Payer Enrollment Specialist to join our team. As a key member of our Patient Financial Experience department, you will play a critical role in ensuring the smooth operation of our healthcare services.Key Responsibilities:Compile and maintain accurate data for all...
-
Healthcare Enrollment Specialist
3 weeks ago
Lake Success, NY, USA, United States Northwell Health Full timeJob SummaryWe are seeking a skilled Healthcare Enrollment Specialist to join our team at Northwell Health. In this role, you will be responsible for initiating and processing faculty practice provider enrollments/re-enrollments, including preparing and sending related correspondence, assisting in resolving denials or rejections, and ensuring proper...
-
Payer Enrollment Specialist
3 weeks ago
Grand Rapids, MI , USA, United States University of Michigan Health-West Full timePayer Enrollment SpecialistUniversity of Michigan Health-West is seeking a highly skilled Payer Enrollment Specialist to join our team. As a key member of our Patient Financial Experience department, you will play a critical role in ensuring the smooth operation of our provider credentialing processes.Key Responsibilities:Compile and maintain accurate and...
-
Enrollment Coordinator
1 month ago
Miami, FL , USA, United States Miami Jewish Health Full timeJob Title: Enrollment CoordinatorMiami Jewish Health is a leading provider of healthcare and living options for aging adults in the Southeast. We operate Florida PACE (Program of All-Inclusive Care for the Elderly) Centers, the largest PACE program in Florida, which serves as a health plan, healthcare provider, and social center designed for older adults...
-
Enrollment Coordinator
4 weeks ago
Miami, FL , USA, United States Miami Jewish Health Full timeJob Title: Enrollment CoordinatorMiami Jewish Health is a leading provider of healthcare and living options for aging adults in the Southeast. We operate Florida PACE (Program of All-Inclusive Care for the Elderly) Centers, the largest PACE program in Florida, which serves as a health plan, healthcare provider, and social center designed for older adults...
-
Training Specialist II
3 weeks ago
Raleigh, North Carolina, United States Select Source International Full timeJob Title: Training Specialist IIAt Select Source International, we are seeking a highly skilled Training Specialist II to join our team. As a key member of our organization, you will be responsible for facilitating administrative tasks in our Learning Management System (LMS) and ensuring compliance with global regulations.Key Responsibilities:Develop and...