Payer Enrollment Specialist — CMS & Revalidation Expert

globalcareers-ventrahealth; Mabalacat; On-site; PHP 3,438,000 - 4,688,000; Full time

Benefits offered by this job

Performance-based incentive

Job summary

Ventra Health is seeking a Provider Enrollment Specialist to work with the Enrollment Manager to address payer enrollment issues and denials. You will research, resolve, and enroll payer issues using a mix of internal and external tools, communicating with clients, operations, and CMS via phone, email, or website.

You will follow up on payer enrollment tasks, contact CMS and other payers, manage CMS and state Medicaid applications, and ensure provider numbers are correctly linked to client

Qualifications

• CMS knowledge including requirements and forms for CMS, State Medicaid, and third-party payers.
• HIPAA privacy and security policies and procedures familiarity.
• Strong written and verbal communication skills; detail-oriented and analytical.

Responsibilities

• Research and resolve payer enrollment issues with market locations.
• Contact CMS and payers via phone, email, or website to resolve enrollment issues.
• Complete and submit CMS Medicare, State Medicaid, and other payer applications.

Skills

CMS knowledge

HIPAA knowledge

Communication skills

Analytical skills

Time management

Teamwork

Confidentiality

Problem-solving

Education

Associate's degree

Bachelor's degree

Job description

Ventra Health is seeking a Provider Enrollment Specialist to work with the Enrollment Manager to address payer enrollment issues and denials. You will research, resolve, and enroll payer issues using a mix of internal and external tools, communicating with clients, operations, and CMS via phone, email, or website.

You will follow up on payer enrollment tasks, contact CMS and other payers, manage CMS and state Medicaid applications, and ensure provider numbers are correctly linked to client