Manager, Provider Enrollment

Ventra Health; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a Manager for their Provider Enrollment Department. This role involves managing operations, recruiting, training staff, and enhancing workflow processes. You will be responsible for developing client relationships, coordinating with leadership, and ensuring timely enrollment processes. The ideal candidate will have a background in healthcare administration and strong supervisory skills. This position offers the opportunity to make a significant impact in a dynamic environment focused on delivering exceptional healthcare solutions.

Qualifications

• 2+ years of experience in physician billing or vendor management.
• Strong supervisory and management skills are essential.

Responsibilities

• Oversee Provider Enrollment Department operations and staff management.
• Develop client relationships and provide updates on the credentialing process.

Skills

Supervisory Skills

Management Skills

Healthcare Data Analysis

Financial Reporting

Interpersonal Communication

Decision-Making

Education

High School Diploma

Bachelor’s Degree in Healthcare Administration

Bachelor’s Degree in Business Administration

Tools

CAQH Database

NPI Website

EDI Processes

EFT Processes

ERA Processes

Job description

About Us

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.

Job Summary

• The Manager, Provider Enrollment is primarily responsible for overseeing the Provider Enrollment Department.

Essential Functions and Tasks

• Manages Provider Enrollment Department operations; recruits, selects, orients, trains, coaches, counsels, and disciplines staff. Plans, monitors, appraises, and reviews staff job contributions. Implements cross functional training and succession planning as allowable.
• Develops relationship with clients and provides regular status updates on the credentialing process on a regular basis.
• Coordinates with client leadership and credentialing staff as necessary to obtain documents and additional information necessary to complete enrollment process.
• Holds monthly (or as warranted) meetings with all levels of management to review held claims and address concerns.
• Reports major issues to MGA leadership and makes aware of potential threats/opportunities.
• Develops policies, guidelines, and implements procedures and ensures consistent department-wide implementation. Enhances and standardizes work-flow processes throughout the enrollment cycle to assist in achieving consistency and success.
• Monitors timeliness and effectiveness of department activities.
• Compiles and prepares a variety of reports for management in order to analyze trends and make recommendations.
• Conducts regular meetings with the team and provides suggestions for improvement and decision support.
• Protects and safeguards company and patient information and reports suspicious activity to management.
• Performs special projects and other duties as assigned.

Education and Experience Requirements

• High School diploma or equivalent.
• Bachelor’s Degree in Healthcare Administration, Business Administration, Benefits, or equivalent training and/or experience preferred.
• At least two (2) years of physician billing, hospital billing, or vendor management experience in provider enrollment functions.
• At least one (1) year of supervisory/management/leadership experience preferred.
• Experience with CAQH database, NPI website and maintaining EDI, EFT, and ERA processes preferred.

Knowledge, Skills, and Abilities

• Knowledge of business and financial processes, procedures, and processes.
• Knowledge of medical terminology and anatomy.
• Knowledge of requirements of medical record documentation.
• Strong supervisory/management skills.
• Strong management level oral, written, and interpersonal communication skills.
• Strong financial reporting skills.
• Strong healthcare data analysis skills.
• Strong presentation development and delivery skills.
• Strong word processing, spreadsheet, database, and presentation software skills.
• Strong decision-making skills.