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Provider Enrollment Rep Lead - Part B

  • Job Family: PND > Provider Relationship Account Mgmt
  • Type: Full time
  • Date Posted:
  • Req #: JR38156


  • IN, Indianapolis
  • Massachusetts, Hingham
  • Texas, Denison
  • Pennsylvania, Harrisburg
  • New York, Syracuse
  • Kentucky, Shelbyville
  • Maryland, Baltimore
  • Maine, South Portland



National Government Services is a proud member of Elevance Health’s family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs.                                                

Provider Enrollment Rep Lead

This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years.

The Provider Enrollment Rep Lead will serve as the Part B Provider Enrollment expert. Advises the Center for Medicare and Medicaid Services (CMS) on processes and procedures, resulting impacts and recommends alternatives to make processes more effective/efficient. Provides technical direction, guidance and resources on a day-to-day basis to ensure the accurate and timely processing of applications.

Primary duties may include, but are not limited to:

  • Serves as a first line resource for operations associates for workflow and technical related processes.

  • Answers day-to-day technical questions, encourages a teamwork environment, monitors inventory to ensure workflow remains uninterrupted, handles complex application research and resolution, reviews, interprets and maintains records of service level, quality, accuracy, and productivity.

  • Advises and educates CMS and influences policy, process and procedure development.

  • Interprets CMS Technical Direction Letters and Change Requests in order to develop company processes.

  • Resolves difficult application issues that have been elevated by the provider community.

  • Trains and educates associates on the correct completion of enrollment application.

  • Develops presentations to educate the provider community and presents them at conferences and meetings.

Minimum Requirements:

  • Requires a H.S. diploma and a minimum of 5 years health care related experience; minimum of 3 years Provider Enrollment experience; or any combination of education and experience, which would provide an equivalent background.

  • Ability to travel required.

Preferred Qualifications:

  • A BA/BS degree in related field strongly preferred.

Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.

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