Medicaid Provider Enrollment Auditor

Medicaid Provider Enrollment Auditor

Albany, NY Pay: $32.00 - $35.00 per hour 26-08818

The Medicaid Provider Enrollment Auditor supports the review, verification, and maintenance of Medicaid provider enrollment information. This role reviews provider applications and supporting documentation for completeness, accuracy, and compliance with established requirements. The position requires strong attention to detail, computer and research skills, and the ability to work independently in a production-focused environment. This is an administrative auditing role focused on data verification and document review rather than traditional accounting or financial auditing.

Job Responsibilities

• Review Medicaid provider applications and supporting documentation for completeness, accuracy, and validity.
• Verify information submitted through provider enrollment systems against applicable requirements, policies, and procedures.
• Research and verify provider information using federal and state databases and web-based resources.
• Navigate Medicare PECOS, NPI Registry/NPPES, professional licensing databases, and other verification resources.
• Contact healthcare providers by portal message, email, or telephone to obtain missing information or clarification.
• Enter, maintain, and update provider information in applicable enrollment systems.
• Review detailed and potentially sensitive information for accuracy and completeness.
• Maintain, file, and upload documentation according to established procedures.
• Meet established production, accuracy, and quality standards.
• Maintain organized records and ensure information is processed accurately.
• Perform additional provider enrollment and administrative support duties as assigned.

Job Requirements

• Previous experience in administrative support, data verification, data entry, document review, customer service, or a related function preferred.
• Strong computer skills, including Microsoft Office and internet/database navigation.
• Strong written and verbal communication skills.
• Excellent organizational skills and attention to detail.
• Ability to review detailed information for accuracy and identify discrepancies.
• Ability to research information using web-based databases and verification resources.
• Ability to manage priorities and adapt to changing workload requirements.
• Ability to work independently with minimal supervision and collaboratively within a team.
• Ability to perform repetitive, detail-oriented work while maintaining accuracy and productivity.
• Professional telephone and written communication skills.

Education

• High school diploma or equivalent required.

Work Experience

• Experience reviewing, verifying, or validating detailed or sensitive information preferred.
• Data entry or records-processing experience preferred.
• Healthcare, health insurance, Medicaid, provider enrollment, credentialing, licensing, eligibility, claims, or similar administrative experience preferred.