Provider Enrollment & Payer Solutions Specialist

clarkcareers-ventrahealth; Mabalacat; On-site; PHP 279,000 - 502,000; Full time

Benefits offered by this job

Rewards program

Incentive plan

Referral bonus

Job summary

Ventra Health in the Philippines is seeking a Provider Enrollment Specialist to work with the Enrollment Manager to research and resolve payer enrollment issues and denials, contacting CMS and payers by phone, email, or web.

You will handle CMS Medicare and State Medicaid applications, maintain records, and build relationships with clients and Revenue Cycle Management teams to ensure timely enrollment and compliance.

Qualifications

• Associate's degree (2 years) required; Bachelor's preferred.
• At least 1 year of provider enrollment experience preferred.

Responsibilities

• Performs follow-up with market locations to research and resolve payer enrollment issues.
• Performs follow-up with CMS and other payers via phone, email or website to resolve enrollment issues.
• Manages completion and submission of CMS Medicare and State Medicaid applications.
• Maintains documentation and reporting regarding payer enrollments in process.
• Establishes relationships with Clients, Operations, and Revenue Cycle Management.

Skills

CMS knowledge

HIPAA privacy

Communication skills

Word processing

Analytical skills

Problem solving

Time management

Confidentiality

Education

Associate's degree (2 years)

Bachelor's degree in related field

Tools

CMS systems

Job description

Ventra Health in the Philippines is seeking a Provider Enrollment Specialist to work with the Enrollment Manager to research and resolve payer enrollment issues and denials, contacting CMS and payers by phone, email, or web.

You will handle CMS Medicare and State Medicaid applications, maintain records, and build relationships with clients and Revenue Cycle Management teams to ensure timely enrollment and compliance.