Provider Enrollment Specialist: Payer & CMS Coordination

Ventra Health, Inc.; United States; Remote; USD 52,000 - 68,000; Full time

Benefits offered by this job

Incentive plan

Referral bonus

Job summary

Ventra Health, Inc. is seeking a Provider Enrollment Specialist to work with the Provider Enrollment Manager to identify and resolve payer enrollment issues and denials, contacting CMS and other payers via phone, email, or web.

You will manage CMS Medicare and State Medicaid applications, track revalidation dates, maintain provider demographics across enrollment systems, and collaborate with Clients and Revenue Cycle Management to keep enrollment active and error-free.

Qualifications

• Associate degree required; Bachelor’s preferred.
• Prior provider enrollment experience preferred (1+ year).
• Working knowledge of CMS enrollment requirements and payer processes.

Responsibilities

• Research and resolve payer enrollment issues and denials.
• Communicate with CMS and payers by phone, email, or website to resolve enrollment issues.
• Submit CMS Medicare, State Medicaid, and other payer applications.
• Track and ensure provider numbers are established and linked to the correct client groups and systems.
• Maintain enrollment documentation and reporting; retain CMS application records.

Skills

CMS enrollment knowledge

HIPAA knowledge

Strong communication

Attention to detail

Analytical skills

Time management

Team oriented

Confidentiality

Problem solving

Independent working

Education

Associate's degree (2 years)

Bachelor's degree in related field

Tools

MS Office

CMS portals

Job description

Ventra Health, Inc. is seeking a Provider Enrollment Specialist to work with the Provider Enrollment Manager to identify and resolve payer enrollment issues and denials, contacting CMS and other payers via phone, email, or web.

You will manage CMS Medicare and State Medicaid applications, track revalidation dates, maintain provider demographics across enrollment systems, and collaborate with Clients and Revenue Cycle Management to keep enrollment active and error-free.