Provider Enrollment Specialist

🔥 20 hours 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

• Work with the Provider Enrollment Manager to identify provider payer enrollment issues or denials • Research, resolve, and enroll payer issues using proprietary and external tools • Contact clients, operations personnel, CMS, and other payers by phone, email, or website • Research and resolve payer enrollment issues with market locations and payers • Complete and submit CMS Medicare, State Medicaid, and third-party payer applications • Track and follow up to establish provider numbers and link them to appropriate client group entities and software systems • Maintain documentation, reporting, and records for payer enrollments and completed CMS applications • Build working relationships with clients, Operations, and Revenue Cycle Management • Track payer revalidation dates and submit applications to maintain active enrollment and prevent deactivation • Maintain provider demographics and enrollment status in applicable systems • Add providers to 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 CMS, State Medicaid, and third-party payer application requirements, prerequisites, forms, 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 • Ability to communicate with diverse personalities professionally

🏖️ Benefits

• Full-time day shift • Eligibility for Ventra's performance-based incentive plan • Discretionary incentive bonus in accordance with company policies • Referral bonus opportunity

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