Provider Enrollment Analyst/Credentialing

Provider Enrollment Analyst/Credentialing

WPS Health Solutions

Madison, WI • On-site, Remote

$20.50/hr

Full-time

Medical, Dental, Retirement, PTO

Posted 5 days ago


Job description

U.S. Citizenship is required for this position due to CMS guidelines.

Role Snapshot

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: July 14, 2026
  • 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
  • Work Location: Remote

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
  • U.S. Citizenship required.
  • 1 or more years of business experience, including working in the insurance industry, claims processing, health care credentialing, 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 credentialing, 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 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
  • Professional and Leadership Development Programs
  • Review additional benefits: (https://www.wpshealthsolutions.com/careers/)

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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This position supports services under Centers for Medicare & Medicaid Services (CMS) contract(s).  As such, the role is subject to all applicable federal regulations, CMS contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. CMS contractors and their personnel are subject to screening and background investigation prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services.




Frequently asked questions

Q: What skills or qualities help someone succeed as a Credentialing Analyst?

A: To succeed as a Credentialing Analyst, key technical skills include proficiency in electronic health record (EHR) systems, knowledge of medical terminology, and expertise in credentialing software and regulatory compliance. Soft skills such as strong analytical and problem-solving abilities, effective communication and interpersonal skills, and attention to detail are also crucial for navigating complex credentialing processes and building strong relationships with healthcare providers. By combining these technical and soft skills, Credentialing Analysts can efficiently manage credentialing workflows, ensure compliance, and drive career growth through opportunities for professional development and leadership roles.

Q: What is the career path for a Credentialing Analyst?

A: A Credentialing Analyst's typical career progression involves starting as a junior analyst, where they verify and process provider credentials, then advancing to a mid-level role as a Credentialing Specialist, overseeing credentialing operations and implementing process improvements. At the senior level, a Credentialing Manager or Director oversees the credentialing department, develops strategic plans, and ensures compliance with regulatory requirements. Throughout their career, Credentialing Analysts can develop skills in data analysis, project management, and leadership, which can lead to opportunities in healthcare operations, compliance, or management roles.



WPS Health Solutions job posting for a Provider Enrollment Analyst/Credentialing in Madison, WI with a salary of $21 Hourly and benefits including Medical, Dental, PTO, and Retirement with a map of Madison location.