Provider Enrollment Specialist

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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

• Works in conjunction with the Provider Enrollment Manager to identify Provider Payer Enrollment issues or denials • Researches, resolves, and enrolls any payer issues, utilizing a variety of proprietary and external tools • Contacts clients, operations personnel, and Centers for Medicare & Medicaid Services (CMS) via phone, email, or website • Performs follow-up with market locations to research and resolve payer enrollment issues • Manages the completion and submission of CMS Medicare, State Medicaid and any other third-party payer applications • Maintains documentation and reporting regarding payer enrollments in process • Establishes close working relationships with Clients, Operations, and Revenue Cycle Management team • Proactively obtains, tracks, and manages all payer revalidation dates • Maintains provider demographics in all applicable enrollment systems • Performs special projects and other duties as assigned

🎯 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 specific application requirements for Centers for Medicare & Medicaid Services (CMS), State Medicaid and all third-party payers • 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 skills • Strong analytical skills • Strong decision-making skills • Strong problem-solving skills • Strong organizational skills • Strong time management skills • Ability to ensure the complex enrollment packages are complete and correct • Ability to work cohesively in a team-oriented environment • Ability to foster good working relationships with others both within and outside the organization • Ability to work independently and require little supervision • Ability to maintain strict confidentiality

🏖️ Benefits

• Ventra performance-based incentive plan • Referral Bonus