Provider Enrollment Specialist — CMS & Payer Enrollments

Ventra Health, Inc.; Mabalacat; Hybrid; PHP 240,000 - 420,000; Full time

Benefits offered by this job

Performance-based incentive plan

Referral bonus

Job summary

Ventra Health, Inc. is seeking a Provider Enrollment Specialist to work with the Provider Enrollment Manager to resolve payer enrollment issues and denials using CMS and external tools.

The role involves contacting CMS, payers, and clients via phone, email, or website to research and enroll payer issues. The position requires an Associate's degree (2 years) with preference for a Bachelor's degree and at least 1 year of enrollment experience.

Qualifications

• Associate's degree (2 years) required; Bachelor's degree preferred.
• At least 1 year of provider enrollment experience preferred.
• Working knowledge of CMS, Medicaid, and third-party payers requirements.

Responsibilities

• Research and resolve payer enrollment issues with CMS and payers.
• Submit CMS Medicare, State Medicaid, and other payer applications.
• Maintain provider enrollment data across systems and documentation.
• Coordinate with clients, operations, and Revenue Cycle Management teams.
• Track payer revalidation dates and ensure active enrollment.

Skills

CMS enrollment

HIPAA privacy & security

Verbal & written communication

Analytical skills

Organizational skills

Problem-solving

Teamwork

Independence

Education

Associate's degree (2 years)

Bachelor's degree in related field

Tools

CMS portals

CMS systems

Job description

Ventra Health, Inc. is seeking a Provider Enrollment Specialist to work with the Provider Enrollment Manager to resolve payer enrollment issues and denials using CMS and external tools.

The role involves contacting CMS, payers, and clients via phone, email, or website to research and enroll payer issues. The position requires an Associate's degree (2 years) with preference for a Bachelor's degree and at least 1 year of enrollment experience.