Provider Enrollment Pro — Incentives Eligible

Ventra Health, Inc.; Central Luzon; Presencial; PHP 3.266.000 - 4.774.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Performance-based incentive

Rewards & Recognition program

Descripción de la vacante

Ventra Health, Inc. is seeking a Provider Enrollment Specialist to work with the Enrollment Manager to identify issues or denials and to enroll payers using diverse tools. You will contact CMS, clients, and operations to resolve enrollment problems and maintain accurate provider records.

This role requires building strong internal and external relationships, tracking revalidations, and ensuring all enrollment packages are complete for ongoing active enrollment across multiple payer programs.

Formación

• Associate's degree (2 years) required; Bachelor's degree preferred.
• At least 1 year of provider enrollment experience preferred.
• Working knowledge of CMS enrollment requirements and third-party payers including required documentation.
• Working knowledge of HIPAA Privacy & Security policies.
• Strong communication, organizational and interpersonal skills.

Responsabilidades

• Works with Provider Enrollment Manager to identify payer enrollment issues or denials.
• Researches, resolves, and enrolls payer issues using proprietary and external tools.
• Contacts clients, operations personnel, and CMS via phone, email, or website.
• Performs follow-up with market locations to resolve enrollment issues.
• Manages CMS/Medicaid/third-party payer applications and submits them.
• Tracks and ensures provider numbers are linked to the correct client group and systems.
• Maintains documentation and reporting on payer enrollments in process.
• Establishes relationships with Clients, Operations, and Revenue Cycle Management teams.
• Monitors payer revalidation dates and completes required applications to maintain active enrollment.
• Maintains provider demographics in enrollment systems and updates provider records.
• Adds providers to systems and maintains enrollment status for claims processing.
• Performs special projects and other duties as assigned.

Conocimientos

CMS knowledge

HIPAA compliance

Communication skills

Time management

Teamwork

Analytical skills

Problem solving

Organization

Educación

Associate's degree (2 years)

Bachelor's degree in any related field

Herramientas

MS Word

MS Excel

CMS enrollment portals

CRM software

Descripción del empleo

Ventra Health, Inc. is seeking a Provider Enrollment Specialist to work with the Enrollment Manager to identify issues or denials and to enroll payers using diverse tools. You will contact CMS, clients, and operations to resolve enrollment problems and maintain accurate provider records.

This role requires building strong internal and external relationships, tracking revalidations, and ensuring all enrollment packages are complete for ongoing active enrollment across multiple payer programs.