Payer Enrollment Specialist: CMS & Compliance

Ventra Health; Morong; On-site; PHP 279,000 - 502,000; Full time

Benefits offered by this job

Performance-based incentive

Job summary

Ventra Health is seeking a Provider Enrollment Specialist to work with the Provider Enrollment Manager to resolve payer enrollment issues and denials. The role involves researching, resolving, and enrolling payer matters using CMS and external tools, with communication to clients, operations, and CMS via phone, email, or website.

The position requires coordinating CMS Medicare and State Medicaid applications, maintaining provider demographics, and ensuring enrollment records are accurate and

Qualifications

• Associate's degree (2 years) required and Bachelor's degree in any related field preferred.
• At least 1 year of provider enrollment experience preferred.

Responsibilities

• Research and resolve payer enrollment issues.
• Contact CMS and other payers via phone, email, or website to resolve enrollment issues.
• Process CMS Medicare and State Medicaid applications.
• Maintain documentation and reporting on payer enrollments.
• Maintain provider demographics in enrollment systems.

Skills

CMS enrollment knowledge

HIPAA privacy knowledge

Communication skills

Detail orientation

Analytical skills

Time management

Team collaboration

Confidentiality

Education

Associate's degree (2 years)

Bachelor's degree in related field

Tools

Enrollment software

Job description

Ventra Health is seeking a Provider Enrollment Specialist to work with the Provider Enrollment Manager to resolve payer enrollment issues and denials. The role involves researching, resolving, and enrolling payer matters using CMS and external tools, with communication to clients, operations, and CMS via phone, email, or website.

The position requires coordinating CMS Medicare and State Medicaid applications, maintaining provider demographics, and ensuring enrollment records are accurate and