Provider Enrollment Specialist

🔥 7 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 10%

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Ventra Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2021

🏥 Healthcare

☁️ SaaS

🤝 B2B

Healthcare • SaaS • B2B

Ventra Health is a healthcare revenue cycle management (RCM) company that provides end-to-end medical billing, coding, claims management, denial prevention, payer contracting, and collections services for hospitals, health systems, and physician practices across the U. S. Its offerings combine domain expertise and white‑glove client service with proprietary data and AI-powered platforms—vCision (AI & automation) and vSight (data & analytics)—to improve reimbursement, reduce denials, accelerate cash collections, and deliver measurable RCM performance improvements. Ventra emphasizes enterprise service delivery, provider education, compliance and coding audits, patient responsibility management, and payer strategy, serving thousands of providers and facilities nationwide.

📋 Description

• Identify provider payer enrollment issues or denials with the Provider Enrollment Manager • Research and resolve payer enrollment issues through proprietary and external tools • Contact clients, operations personnel, CMS, and other payers by phone, email, or website • Follow up with market locations to research and resolve payer enrollment issues • Complete and submit CMS Medicare, State Medicaid, and third-party payer applications • Track and follow up to establish provider numbers and link them to the appropriate client group entities and software systems • Maintain documentation and reporting for payer enrollments in process • Retain records related to completed CMS applications • Build working relationships with clients, Operations, and Revenue Cycle Management • Obtain, track, and manage payer revalidation dates; submit and track applications to maintain active enrollment and prevent deactivation • Maintain provider demographics in applicable enrollment systems • Add providers to applicable systems and maintain information so claims are held or released based on enrollment status • Perform special projects and other assigned duties

🎯 Requirements

• Associate's degree (2 years), required • Bachelor's degree in any related field, preferred • At least one (1) year of provider enrollment experience preferred • Working knowledge of application requirements for CMS, State Medicaid, and third-party payers • Knowledge of prerequisites, required forms, completion requirements, supporting documentation, and regulations • Working knowledge of physician HIPAA Privacy & Security policies and procedures • Strong oral, written, and interpersonal communication skills • Strong word processing, spreadsheet, database, and presentation software skills • Strong detail orientation, analytical, decision-making, problem-solving, organizational, and time management skills • Ability to complete and verify complex enrollment packages • Ability to work independently and in a team-oriented, collaborative, fast-paced environment • Ability to maintain strict confidentiality regarding protected provider and health information • Ability to troubleshoot, take initiative, exercise sound judgment, and handle sensitive information appropriately

🏖️ Benefits

• Performance-based incentive plan • Discretionary incentive bonus • Referral bonus • Remote work arrangement