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Provider Enrollment Specialist II at General Dynamics Information Technology - ApplyBlast

Provider Enrollment Specialist II

General Dynamics Information Technology

4 months ago

4.0 on Glassdoor

Raleigh, NC

Hybrid

Full Time

Junior

0 applicants

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About this role

A Provider Enrollment Specialist II at General Dynamics Information Technology ensures compliance for NC Medicaid programs by conducting operational audits and verifying provider qualifications. The role involves processing enrollment applications, validating licenses, performing criminal background checks, and determining entity eligibility based on state business rules. This hybrid position requires significant detail-oriented administrative work to support the healthcare sector's enrollment processes.

Responsibilities

Process provider enrollment applications to ensure regulatory compliance
Validate qualifications of licensed professionals and organizations
Perform and assess criminal background checks using Lexis Nexis
Verify licensure, certification, and accreditations via state boards
Render determinations on entity eligibility to provide services

Skills

Qualifications

High School Diploma or GED2 years of related experience2 years of administrative experienceWorking knowledge of NC Medicaid or HealthcareWorking knowledge of NCTracks