Provider Enrollment QA Specialist (Remote)

Gainwell Technologies LLC; Idaho; Hybrid; USD 60,000 - 75,000; Full time

Job summary

Gainwell Technologies LLC seeks an Associate Professional Quality to monitor and evaluate voice and non-voice interactions, ensuring accuracy, compliance, and high-quality member experiences. You will conduct daily reviews and audits, adhering to client, company, and regulatory standards while supporting quality initiatives.

The role emphasizes data-driven QA, collaboration with centralized and account teams, and opportunities to improve processes.

Qualifications

• Bachelor's degree or equivalent education and experience; QA fundamentals required.
• Minimum 3 years in Provider Enrollment or Credentialing; 5 years preferred.
• Strong collaboration and communication across diverse teams.

Responsibilities

• Provide quality assurance and analysis of Provider Enrollment applications to ensure compliance with Federal and State policies and guidelines.
• Meet established production and quality standards while processing and supporting complex provider enrollment requirements.
• Participate in calibration sessions and stakeholder engagement meetings to ensure consistency and alignment.
• Identify, escalate, and support the resolution of quality issues, coaching opportunities, and process improvement needs.
• Use data-driven insights, automation, and industry best practices to recommend process and policy improvements and increase QA efficiency and effectiveness.

Skills

Quality assurance

Cross-functional collaboration

Data analysis

Communication

Education

Bachelor's degree

Tools

MS Office Suite

SharePoint

CXOne

Verint

Job description

Gainwell Technologies LLC seeks an Associate Professional Quality to monitor and evaluate voice and non-voice interactions, ensuring accuracy, compliance, and high-quality member experiences. You will conduct daily reviews and audits, adhering to client, company, and regulatory standards while supporting quality initiatives.

The role emphasizes data-driven QA, collaboration with centralized and account teams, and opportunities to improve processes.