Provider Enrollment and Compliance Analyst

Job Summary

In addition to leading facility enrollment work this position will also provide flexible support to professional provider enrollment activities and strategic system projects as business needs require. The role functions as a hybrid between an enrollment coordinator and analyst requiring strong regulatory knowledge attention to detail and the ability to apply CMS enrollment rules consistently across a large integrated healthcare system.

• Manage all CMS Medicare Medicaid and Commercial enrollments for hospitals facilities and organizational billing entities across the health system.
• Prepare submit and track CMS-855 applications state Medicaid enrollment forms commercial enrollment forms revalidations and payer notifications.
• Maintain accurate enrollment records for facility and hospital NPIs PTANs taxonomies ownership disclosures and practice locations
• Ensure timely filing of changes updates additions and terminations in accordance with CMS and state regulatory timelines.
• Serve as the subject matter expert for facility enrollment compliance identifying risks associated with delayed or incomplete filings.
• Interpret and apply CMS and Medicaid enrollment regulations to support compliant billing and reduce audit exposure.
• Monitor enrollment status and proactively address pending expiring or at-risk enrollments.
• Partner with Revenue Integrity Professional Billing Compliance New Programs & Integrations and Operational leaders to resolve enrollment-related impacts.
• Respond to payers CMS or Medicaid inquiries related to enrollment status or documentation partnering with internal stakeholders as needed.
• Provide support across all provider enrollment work during high-volume periods and coverage gaps.
• Support standardization of facility enrollment workflows documentation requirements and internal guidance.

• Bachelors Degree or equivalent in business Healthcare Administration Health Information Management or a related field OR equivalent relevant experience.

• 2 years of relevant experience in experience in provider enrollment facility enrollment credentialing or revenue cycle operations.
• Working knowledge of CMS Medicare and Medicaid enrollment requirements including CMS-855 forms and revalidation processes.
• Demonstrated ability to manage complex detail-driven work with regulatory deadlines and compliance implications.
• Strong written and verbal communication skills.

As a team member at Corewell Health you will play an essential role in delivering personalized health care to our patients members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators leaders and innovators that continue to build on one shared mission statement - to improve health instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

• Comprehensive benefits package to meet your financial health and work/life balance goals. Learn more here.
• On-demand pay program powered by Payactiv
• Discounts directory with deals on the things that matter to you like restaurants phone plans spas and more!
• Optional identity theft protection home and auto insurance
• Traditional and Roth retirement options with service contribution and match savings
• Eligibility for benefits is determined by employment type and status

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Corewell Health is committed to providing a safe environment for our team members patients visitors and community. We require a drug-free workplace and require team members to comply with the MMR Varicella Tdap and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process to perform the essential functions of a job or to enjoy equal benefits and privileges of employment due to a disability pregnancy or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race color national origin sex disability age religion genetic information marital status height weight gender pregnancy sexual orientation gender identity or expression veteran status or any other legally protected category.

An interconnected collaborative culture where all are encouraged to bring their whole selves to work is vital to the health of our organization. As a health system we advocate for equity as we care for our patients our communities and each other. From workshops that develop cultural intelligence to our inclusion resource groups for people to find community and empowerment at work we are dedicated to ongoing resources that advance our values of diversity equity and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.