Provider Enrollment Pro: CMS & Payer Solutions

Ventra Health, Inc.; Northern (KY); Hybrid; USD 45,000 - 65,000; Full time

Benefits offered by this job

Performance-based incentive plan

Referral bonus

Discretionary incentive bonus

Job summary

Ventra Health, Inc. is seeking a Provider Enrollment Specialist to work with the Provider Enrollment Manager on payer enrollment issues, including CMS CMS and Medicaid applications. The role requires coordination with clients, operations, and CMS via calls, email, or portal.

The position emphasizes accurate enrollment packages, timely revalidation dates, and maintaining provider demographics across enrollment systems. Experience with CMS and HIPAA is valued.

Qualifications

• Associate degree required; Bachelor’s preferred in any related field.
• 1+ year provider enrollment experience preferred.

Responsibilities

• Identify payer enrollment issues and denials; research, resolve, enroll with CMS and payers.
• Follow up with CMS, state Medicaid, and other payers to resolve enrollment issues.
• Submit CMS Medicare, State Medicaid and third‑party payer applications.
• Maintain provider demographics and ensure enrollment status links to client systems.
• Document and report payer enrollments; retain CMS application records.

Skills

CMS enrollment

HIPAA privacy

communication skills

detail orientation

analytical skills

organizational skills

time management

team collaboration

confidentiality

problem-solving

Education

Associate's degree

Bachelor's degree in related field

Tools

Excel

Word

PowerPoint

CRM systems

Job description

Ventra Health, Inc. is seeking a Provider Enrollment Specialist to work with the Provider Enrollment Manager on payer enrollment issues, including CMS CMS and Medicaid applications. The role requires coordination with clients, operations, and CMS via calls, email, or portal.

The position emphasizes accurate enrollment packages, timely revalidation dates, and maintaining provider demographics across enrollment systems. Experience with CMS and HIPAA is valued.