Provider Enrollment Specialist II

General Dynamics Information Technology created the premier provider of high-tech IT solutions to the government IT market. Together as General Dynamics Information Technology, we deliver cost-effective, next-generation IT solutions and services to the Department of Defense, the intelligence community and federal civilian agencies as they modernize their information systems.

GDIT is currently seeking a Provider Enrollment Specialist II in Raleigh NC to join our team. In this role you will be a change agent by conducting operational audits and verifying that operational procedures are followed correctly for the Provider Enrollment Section. This section is responsible for enrolling providers for the NC Medicaid Programs. This involves ensuring that providers are licensed and accredited for the services enrolling to provide and do not have a criminal background. This is a hybrid role, 1 day in the office.

RESPONSIBILITIES:

• Process provider enrollment applications to ensure new and currently enrolled providers are within compliance within NC State regulations.  
• Validate the qualifications of licensed professionals, organizational members or organizations
• Render a determination that an organization or entity meets the established qualifications, requirements and/or standards to provide a service or procedure as outlined in the State business rules/desk procedures.
• Perform and assess the background check through Lexis Nexis, AAR and PPTD.
• Perform source verification of licensure, certification, endorsements and accreditations through Lexis Nexis or State Licensure Board.
• Deny providers that do not meet the requirements.
• Meet performance quality standards on a daily basis.
• Meet performance quantity standards on a daily basis.

QUALIFICATIONS:

• HS/GED; 2+ years of experience
• Requires 2 years administrative experience
• Knowledge of NC Medicaid or Healthcare
• Working knowledge of NCTracks
• Working knowledge or provider enrollment pega
• Working knowledge of provider enrollment requirements
• Proficient with Microsoft suite

Desired Skills and Experience:

• Credentialing experience
• Customer service experience
• Attention to detail
• Strong verbal and written communication

ATTRIBUTES FOR SUCCESS:

As a trusted systems integrator for more than 50 years, General Dynamics Information Technology provides information technology (IT), systems engineering, professional services and simulation and training to customers in the defense, federal civilian government, health, homeland security, intelligence, state and local government and commercial sectors. With approximately 32,000 professionals worldwide, the company delivers IT enterprise solutions, manages large-scale, mission-critical IT programs and provides mission support services. GDIT is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other protected class.

The likely hourly rate for this position is between $18.50 - $20.00. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

Weekly Scheduled Hours:

40

Clearance Level Must Currently Possess:

None

Clearance Level Must Be Able To Obtain:

None

Public Trust/Other Required:

None

Travel Required:

None

Telecommuting Options:

Hybrid