Provider Enrollment and Compliance Analyst

Job Summary

The Provider Enrollment and Compliance Analyst supports the Revenue Cycle by managing all facility – and hospital-focused enrollment activities with the Centers for Medicare and Medicaid Services (CMS), state Medicaid programs and other commercial payers. This role is accountable for initial enrollments, revalidations, changes, updates and terminations to ensure ongoing billing compliance and minimize enrollment-related revenue risk.

In addition to leading facility enrollment work, this position will also provide flexible support to professional provider enrollment activities and strategic system projects as business needs require. The role functions as a hybrid between an enrollment coordinator and analyst, requiring strong regulatory knowledge, attention to detail and the ability to apply CMS enrollment rules consistently across a large, integrated healthcare system.

Essential Functions

Manage all CMS Medicare, Medicaid and Commercial enrollments for hospitals, facilities and organizational billing entities across the health system.
Prepare, submit, and track CMS-855 applications, state Medicaid enrollment forms, commercial enrollment forms, revalidations and payer notifications.
Maintain accurate enrollment records for facility and hospital NPIs, PTANs, taxonomies, ownership disclosures and practice locations
Ensure timely filing of changes, updates, additions and terminations in accordance with CMS and state regulatory timelines.
Serve as the subject matter expert for facility enrollment compliance, identifying risks associated with delayed or incomplete filings.
Interpret and apply CMS and Medicaid enrollment regulations to support compliant billing and reduce audit exposure.
Monitor enrollment status and proactively address pending, expiring, or at-risk enrollments.
Partner with Revenue Integrity, Professional Billing, Compliance, New Programs & Integrations and Operational leaders to resolve enrollment-related impacts.
Respond to payers, CMS, or Medicaid inquiries related to enrollment status or documentation, partnering with internal stakeholders as needed.
Provide support across all provider enrollment work during high-volume periods and coverage gaps.
Support standardization of facility enrollment workflows, documentation requirements, and internal guidance.

Qualifications

Required

Bachelor's Degree or equivalent in business, Healthcare Administration, Health Information Management or a related field OR equivalent relevant experience.

2 years of relevant experience in experience in provider enrollment, facility enrollment, credentialing or revenue cycle operations.
Working knowledge of CMS Medicare and Medicaid enrollment requirements, including CMS-855 forms and revalidation processes.
Demonstrated ability to manage complex, detail-driven work with regulatory deadlines and compliance implications.
Strong written and verbal communication skills.

About Corewell Health

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

How Corewell Health cares for you

Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.
On-demand pay program powered by Payactiv
Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
Optional identity theft protection, home and auto insurance
Traditional and Roth retirement options with service contribution and match savings
Eligibility for benefits is determined by employment type and status

Primary Location

SITE - Corewell Health Place - 100 Corewell Drive NW - Grand Rapids

Department Name

Revenue Cycle Provider Support and Enrollment Svcs - Corporate

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

Hours of Work

8:00 a.m. - 4:00 p.m.

Days Worked

Monday - Friday

Weekend Frequency

N/A

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Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.