Medicare & Medicaid Enrollment Analyst
Tasks
- Build and maintain revalidation tracking systems
- Collaborate with billing and revenue cycle teams
- Communicate enrollment policy impacts
- Coordinate Medicare electronic signatures
- Coordinate state Medicaid enrollment requirements
- Coordinate supporting documentation for revalidations
- Document and report enrollment milestones
- Ensure CMS and MAC compliance
- Escalate delayed or high risk applications
- Follow up with Medicare contractors
- Follow up with state Medicaid agencies
- Maintain audit ready enrollment files
- Manage Medicare enrollment maintenance
- Monitor Medicaid application status
- Monitor due dates and enrollment expirations
- Monitor policy changes impacting enrollment
- Oversee Medicare revalidations
- Provide revalidation guidance
- Provide status updates to stakeholders
- Research billing delays and claim denials
- Resolve Medicaid application deficiencies
- Resolve reimbursement issues
- Submit Medicaid revalidation applications
- Submit Medicare revalidations in PECOS
- Support internal audits and accreditation reviews
- Track PTAN assignments and approval status
Perks/Benefits
- N/A
Skills/Tech-stack
CAQH | CMS Regulations | Claim Denials | CredentialStream | Credentialing | Cycle management | Data reporting | Electronic Signatures | Enrollment Revalidation | Enrollment Tracking | Medicaid | Medicare Administrative Contractor | PECOS | PTAN | Process Improvement | Project Management | Provider onboarding | Regulatory Compliance | Reimbursement | Revenue Cycle | Revenue Cycle Management
Education
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