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Role Description

This role involves acting as the enrollment liaison between Gainwell Technologies, Idaho Department of Health & Welfare (Medicaid Division), and the Idaho Medicaid provider community.

• Review and process initial provider enrollment applications per State requirements
• Update provider changes, certifications, and license updates
• Navigate multiple systems, licensing, and medical certification websites to obtain updates
• Follow up with providers on outstanding issues within contractual guidelines
• Provide excellent customer service with professional verbal and written abilities while meeting documented quality standards

Qualifications

• Highly motivated self-starter with 3+ years’ experience working in the healthcare industry, preferably credentialing or regulatory
• Strong Microsoft Office skills and experience working with business solutions software
• Proven experience with issue resolution focused on research, provider enrollment, requirement compliance, and customer service
• Ability to investigate complex inquiries while leveraging requirements to promote successful outcomes
• Strong written and verbal communication skills
• Strong organization and time management skills

Requirements

• This is a 100% remote position with 8-hour shifts scheduled Monday through Friday during standard business operating hours
• Fast-paced, high-volume, highly visible role requiring strong attention to detail while delivering documented, high-quality analytical support within established service level agreement (SLA) timelines and operational standards
• Utilize claims systems, reporting tools, and operational documentation to review pharmacy claims, validate reimbursement logic, and support claims accuracy and process improvement initiatives
• Investigate complex inquiries, communicate findings and resolutions to internal and external stakeholders via secure messaging, email, or verbal communication, and document all activity within designated system tools
• Work both independently and collaboratively with cross-functional teams while supporting operational goals and performance expectations

Benefits

• Eligible employees may participate in Gainwell’s comprehensive benefits program, which includes medical, dental, vision, 401(k), paid time off, and other employee wellness and support programs
• Generous, flexible vacation policy
• 401(k) employer match
• Comprehensive health benefits
• Educational assistance
• Leadership and technical development academies to help build your skills and capabilities