Provider Enrollment Analyst / Credentialing

Davita Inc.; Sioux Falls (SD); Remote; Full time

Job summary

A leading health solutions provider seeks a Provider Enrollment Analyst who will play a vital role in assisting Medicare providers with application processes. The position includes responsibilities such as approving applications and managing extensive documentation while working within a supportive culture that values employee engagement and career development. You will have the chance to work in a remote or hybrid setting, enhancing flexibility and work-life balance.

Benefits

Performance bonuses

401(k) with matching

Health, dental, and telehealth services

Flexible work hours

Competitive paid time off

Qualifications

• 1+ years in business, health insurance, or claims processing.
• Experience interpreting government regulations.
• Ability to analyze work items for accuracy.

Responsibilities

• Approve or deny Medicare applications.
• Verify research and document enrollment info.
• Respond to provider inquiries and ensure timeliness.

Skills

Confidence in navigating computer systems

Effective prioritization

Strong communication skills

Research and problem-solving

Education

High school diploma or equivalent

Associate degree in business administration, insurance, or related fields

Tools

Dual monitors experience

Job description

Description

The Provider Enrollment Analyst will approve, deny, or return applications submitted by Medicare providers. This work is important in helping providers enroll in the Medicare program.

Additional Information:

• Start Date: August 12^th, 2025


• Starting Base Pay: $20.50 per hour


• Training Schedule: (7 Weeks): Monday through Friday, 8:00-4:35pm CST


• Scheduled Shift: Monday through Friday, 6:00am-6:00pm, Flex Scheduling, max of 10 hours per day and 40 hours minimum per week

We are open to remote work in the following approved states:
Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, North Carolina, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin

In this role you will:

• Utilize on-line Medicare files/systems to verify research, update, and document enrollment information.


• Respond to provider/customer enrollment telephone and written inquiries.


• Ensure all provider enrollment data is properly controlled and tracked to ensure applications are approved or denied within standards of timeliness established by department and Centers for Medicare and Medicaid Services (CMS).


• Enter data into on-line national database and internal provider files (PECOS).


• Research and verify proper fees and inspections have been completed on certain suppliers.

How do I know this opportunity is right for me? If you:

• Possess confidence in your skills navigating a computer to process applications efficiently through multiple operating systems.


• Prioritize effectively, stay on task, and work independently.


• Are comfortable critically examining, analyzing and reviewing work items in detail for accuracy.


• Possess strong communication skills, both verbal and written.


• Enjoy research and problem-solving.

What will I gain from this role?

• Helping our providers enroll in Medicare to support the senior community.


• Having the opportunity to earn more by being a top performer.


• Enjoying flexible work hours.


• Opportunity to work remotely in the comfort of your home - no driving time, gas costs, or wear and tear on your vehicle.


• Experience working in an environment that serves our Nation's military, veterans, Guard and Reserves and Medicare beneficiaries.


• Working in a continuous performance feedback environment.

Minimum Qualifications

• High school diploma or equivalent.


• 1 or more years of business experience, including working in the insurance industry, claims processing, health care credentialling, billing or medical reimbursement.

Preferred Qualifications

• Associate degree in business administration, insurance, healthcare, or related fields.


• 2 or more years of business experience, including working in the insurance industry, claims processing, health care credentialling, billing or medical reimbursement.


• Experience interpreting government regulations and applying to current processes.


• Course work in insurance, medical, customer service and/or financial.


• 1 or more years of computer and navigation experience; preferably working with dual monitors


• Good work ethic and good attendance.


• Ability to communicate effectively over the phone.


• Experience working in a production-based environment.

Remote Work Requirements

• Wired (ethernet cable) internet connection from your router to your computer


• High speed cable or fiber internet


• Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at https://speedtest.net)

Benefits

• Remote and hybrid work options available


• Performance bonus and/or merit increase opportunities


• 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)


• Competitive paid time off


• Health insurance, dental insurance, and telehealth services start DAY 1


• Employee Resource Groups


• Professional and Leadership Development Programs


• Review additional benefits: (https://www.wpshealthsolutions.com/careers/fulltime_benefits.shtml)

Who We Are

WPS Health Solutions is a leading not-for-profit health insurer and federal government contractor headquartered in Wisconsin. WPS offers health insurance plans for individuals, families, seniors, and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS Health Solutions has been making health care easier for the people we serve for more than 75 years. Proud to be military and veteran ready.

Culture Drives Our Success

WPS' Culture is where the great work and innovations of our people are seen, fueled, and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce-both current and future-to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.

We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition.

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Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.