Coordinator II

Randstad USA; Pawtucket (RI); Remote; USD 26,000 - 27,000; Full time

Job summary

Randstad USA is seeking an Enrollment Validation Specialist to join a member-first, collaborative team supporting Medicare alignment and provider services. This remote role offers a daytime schedule with no weekend shifts and requires meticulous data verification across healthcare systems.

You will validate PCP assignments, handle high-volume inquiries, and ensure CMS compliance while using MS Excel. The ideal candidate has 1+ year in healthcare eligibility and proficiency with MS Office.

Qualifications

• High School Diploma or GED required.
• 1+ years of experience in healthcare eligibility, enrollment, provider networks, or CMS guidelines.
• Working knowledge of healthcare billing/claims platforms (e.g., QNXT or similar).
• Comfortable conducting outbound verification calls and entering high-volume data accurately.
• Proficient in Microsoft Office (Excel, Outlook, Word).

Responsibilities

• Research member enrollment data across multiple healthcare systems and resolve discrepancies.
• Validate PCP assignments and process timely updates for Medicare members.
• Conduct outbound outreach to obtain Verification of Chronic Conditions (CSNP).
• Track and resolve high-volume eligibility inquiries and state agency updates using MS Excel.
• Maintain strict accuracy, turnaround times, and CMS compliance metrics.

Skills

healthcare eligibility

enrollment

provider networks

Education

High School Diploma or GED

Tools

QNXT

Job description

We are looking for dedicated Enrollment Validation Specialists to join a collaborative, member-first team supporting Medicare alignment and provider services. If you thrive on independent problem-solving, enjoy high-accuracy work, and want a consistent daytime schedule with zero weekend shifts, this remote role is an ideal fit.

Key Responsibilities

• Research member enrollment data across multiple healthcare systems and resolve discrepancies.
• Validate Primary Care Provider (PCP) assignments and process timely updates for Medicare members.
• Conduct outbound outreach to obtain Verification of Chronic Conditions (CSNP).
• Track and resolve high-volume eligibility inquiries and state agency updates using MS Excel.
• Maintain strict accuracy, turnaround times, and CMS compliance metrics.

Required & Preferred Qualifications

• High School Diploma or GED required (Associate/Bachelor's degree welcomed).
• 1+ years of experience in healthcare eligibility, enrollment, provider networks, or CMS guidelines.
• Working knowledge of healthcare billing/claims platforms (e.g., QNXT or similar).
• Comfortable conducting outbound verification calls and entering high-volume data accurately.
• Proficient in Microsoft Office (Excel, Outlook, Word).

salary: $19.05 - $19.06 per hour

shift: First

work hours: 8 AM - 4:30 PM

education: High School

Skills

• healthcare eligibility
• enrollment
• provider networks

Qualifications

• Years of experience: 1 year
• Experience level: Experienced

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact [e-mail].

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Experience

• Experienced
• 1 year