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Healthcare Regulatory Specialist

2 months ago

Columbia, Maryland, United States C-HIT Full time
Job Overview

C-HIT is seeking a skilled professional to join our team as a Provider Enrollment Analyst.

Key Responsibilities:

  • Act as an internal consultant, providing guidance and support to assist Appeals specialists, Project Managers, and QA Managers in the development of written decisions on appeals or rebuttals.
  • Deliver high-quality customer service to providers, suppliers, and appointed representatives regarding the submission, processing, and issuance of decisions for rebuttals, CAPs, and reconsideration requests.
  • Understand and properly apply federal policies, regulations, and systems in response to providers challenging provider enrollment administrative actions rendered by CMS.
  • Follow detailed instructions when receiving, processing, and rendering written decisions.
  • Participate in business decision-making by offering qualitative feedback, recommendations, and discussing what-if scenarios.
  • Analyze and influence time-sensitive case responses.
  • Coach, support, and cross-train with peers, inputting case details in requisite systems.
  • Occasional travel may be required for in-person meetings, trainings, and presentations.

Requirements:

  • Possess either a 4-year degree from an accredited institution with at least one year of experience in healthcare regulatory interpretation/application and/or healthcare compliance, or without a Bachelor's Degree with at least six years of experience in healthcare regulatory interpretation/application and/or healthcare compliance.

C-HIT is an Equal Opportunity Employer, including disability and veterans.