Provider Enrollment Rep I

* Position is eligible for Remote / Work from Home opportunity *

Hiring Manager: Kathie Wokasch

Department: Iowa Provider Enrollment

Talent Partner: Elizabeth Fleming

Job Grade: N11

As a condition of employment, physical work location must be in one of the 50 states or the District of Columbia.

Notice of Collection & Privacy Policy for Applicants Residing in California: California Applicant Privacy Policy | Noridian (noridiansolutions.com)

Job Title

Provider Enrollment Representative I

Job Summary

The Provider Enrollment Representative I completes routine enrollment tasks in support of the provider enrollment team. This position researches and controls incoming applications and correspondence to ensure the work is properly categorized. This position reviews and processes a high volume of prospective provider enrollment applications

Key Performance Indicators

Attention to detail and accuracy

Strong interpersonal communication skills

Organization, time management, and critical thinking skills

Essential Functions

Key Duties/Responsibilities/Accountabilities

Researches and controls incoming applications and correspondence to ensure work is properly categorized

Enters data into internal document management and workflow systems

Provides quality check on the provider enrollment data and enters application information into claims processing systems

Manages inbound/outbound online FAX queues to and from providers

Quality assurance checks of claims processing system enrollment data

Creates and mails notification letters

Completes application returns and/or application acknowledgement process

Support other enrollment functions such as status calls, basic data entry, special mailings, etc.

Reviews, researches, and processes provider enrollment applications abiding by contract regulations, internal policies, and guidelines

Coaches providers through the enrollment process and provides inbound phone support

Initiates requests for information to complete the online enrollment process

Verifies credentialing information and completes fraud detection and prevention

Non-Essential Duties and Functions

Supports team on special projects and assignments

Other duties as assigned

Special projects as assigned

Minimum Qualifications

High School diploma or GED

6 months' clerical experience

Advanced computer skills, keyboarding, and data entry skills

Experience with computer programs such as: Microsoft Word, Excel, Access, Outlook and SharePoint

Preferred Qualifications

Above requirements and the following:

Knowledge of provider enrollment workload definitions, enrollment terminology, enrollment forms, and basic regulations, policies, and procedures

Proficient in Microsoft Office Applications

12 months' provider enrollment experience

Environment and Cognitive/Physical Demands

Office Environment

Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve

Requires prolonged sitting and telephone use

Requires the use of office equipment such as computer terminals, telephones, copiers and printers

Infrequent lifting to 15 pounds

Infrequent stooping

Segregation of Duties

Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to: Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian Compliance Program and any other applicable laws, rules and regulations.

Statement of Other Duties

This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions. Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or management.

Total Rewards Package:

Health, Dental and Vision Insurance, Voluntary Insurance Plans, Health Savings and Flexible Spending Accounts, 401k and Company Match, Company-paid Life Insurance, Education Assistance Program, Paid Sick Leave, Paid Holidays, Increasing PTO Accrual Plan, Medical/Parental/Disability Leave, Workers Compensation, Retiree Benefits, Employee Assistance Program, Financial and Health Wellness Benefits, Casual Dress, Open Office Setting, and Online Learning System.

CMS Access Compliance and Regulation Contingency Statement

Some positions require compliance with (i) federal and agency specific regulations and related clauses included in Noridian's prime contracts with the Government, (ii) background checks, and (iii) eligibility for a government-issued identification card.

An employee in this position may be required to possess a “Federal Identification Card” (Federal ID) as a condition of employment. Federal ID’s may include one of the following: Personal Identity Verification (PIV) card, Personal Identity Verification-Interoperable (PIV-I) card, a Local-Based Physical Access Card issued by CMS, or a Local-Based Physical Access Card issued by another Federal agency and approved by CMS. Obtaining a Federal ID and continued eligibility for this position may require the successful completion of a Federal Background Investigation performed by the Federal Government and a residency requirement that you have lived in the United States at least three out of the last five years. Failure to obtain a Federal ID may result in the removal from the position or termination of employment.

Equal Employment Opportunity

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

The pay range for this position is $15.66 - $20.60 per hour, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Other Compensation: Incentive Plan & Lifestyle Benefit

This job will be closed 08/26/2026 at 8:00AM CST. No further applications will be considered.

Originally posted on Himalayas