Provider Enrollment Business Analyst

Job Description:

Job Summary

• The Provider Enrollment Business Analyst serves as the analytical backbone of the Provider Enrollment department. This role supports data-driven decision-making by generating, validating, and presenting key performance indicators (KPIs), trends, and insights related to provider enrollment operations. The Data Specialist works closely with team leads, supervisors, and cross-functional stakeholders to ensure the department has clear visibility into operational performance, payer turnaround times, and compliance metrics. This role utilizes a variety of platforms—including Health Information Systems (HIS), CredStream, and internal databases—to build data storylines, develop executive-level performance review decks, and validate the accuracy of reported performance.

Essential Functions and Tasks

• Create, maintain, and distribute recurring reports and dashboards to track provider enrollment volume, cycle time, backlog, and payer responsiveness.
• Develop PowerPoint presentations and executive summary decks for internal and client-facing performance reviews, highlighting enrollment trends, SLAs, and operational KPIs.
• Validate provider enrollment data to ensure reporting accuracy and data integrity across systems, dashboards, and presentations.
• Analyze and summarize performance trends, identifying key areas of success and improvement.
• Partner with Provider Enrollment leadership to support strategic planning, team metrics, and departmental goals.
• Generate ad hoc reports to support payer performance reviews, compliance audits, and process improvement initiatives.
• Use data from HIS platforms, internal tracking systems, and credentialing tools like CredStream to compile story-driven reports.
• Collaborate with IT, data, and analytics teams to optimize data sources and streamline automation of reporting processes.
• Maintain standardized documentation for reporting processes and data definitions.
• Ensure compliance with payer requirements, company policies, and regulatory guidelines in all reporting activities.
• Support special projects and perform other duties as assigned.
• Perform special projects and other duties as assigned.

Education and Experience Requirements

• Bachelor’s degree in Healthcare Administration, Business, Data Analytics, or a related field preferred.
• 2+ years of experience in a healthcare or RCM data analytics/reporting role.
• Experience with provider enrollment, credentialing workflows, or payer interactions is highly desirable.
• Advanced Excel skills required; experience with Power BI, Tableau, or similar reporting tools is a plus.
• Strong proficiency in PowerPoint for building data-driven executive presentations.
• Familiarity with HIS platforms and credentialing software (e.g., CredStream) preferred.

Knowledge, Skills, and Abilities

• Solid understanding of provider enrollment processes and revenue cycle workflows.
• Strong data validation, reconciliation, and QA skills to ensure reporting accuracy.
• Ability to create visually engaging, insightful presentations for leadership and client audiences.
• Excellent analytical thinking and problem-solving skills.
• High attention to detail with a commitment to data consistency and quality.
• Excellent written and verbal communication skills.
• Strong time management skills with ability to manage multiple deadlines.
• Ability to work independently and collaboratively in a team-oriented environment.
• Understanding of HIPAA and data security standards.